The Importance of Prevention
When it comes to children and adolescents, a full lifetime of Healthy Sight may be at stake, so Healthy Sight Counseling assumes special importance in this group.
Amblyopia is a major focus, because unless it is detected and treated early, the opportunity for its reversal and the establishment of normal vision in the involved eye may be lost permanently.
Refractive error is a second area of concern. The World Health Organization (WHO) has estimated that up to 15% of children worldwide have undiagnosed or uncorrected refractive errors. Vision screening is important for all children, because failing to address these simple ametropias can have widespread and far-reaching developmental, psychosocial, and economic consequences.
However, screening is not enough; periodic comprehensive ophthalmic examinations at the hand of a skilled vision care professional are also necessary. Furthermore, just as the child is constantly growing and developing, the child’s eyes are also constantly growing and developing. There can be—and are—growth spurts affecting the child’s eyes as well as the child, frequently marked by significant changes in refractive status, especially during puberty and adolescence. Unless these are recognized and corrected, visual function and performance will be adversely affected, potentially impacting on educational advancement and psychosocial development.
Vision Screening in Children Should Start Early
The goal of vision screening in children is to detect possible amblyopia, strabismus, ocular disease, and refractive error. Early detection will lead to more effective treatment and generally improved outcomes. Early screening and intervention, therefore, may have a positive impact on Healthy Sight for the rest of the child’s life.
Given the possibility of ocular disease and asymmetrical refractive errors or strabismus that could lead to amblyopia, it is crucial that initial screening be performed early—ideally within the first year of life. This early screening is typically performed by the pediatrician as part of routine medical care, where examination with a pen light and direct ophthalmoscope can detect such potentially vision-threatening disorders as congenital ptosis, cataract, corneal opacity, strabismus, and asymmetrical refractive error.
Experimental data suggest that for optimal visual development and the successful establishment of binocularity, potential refractive and non-refractive causes for amblyopia must be detected and treated within the first few months of life. For example, in the case of unilateral congenital cataract, corrective surgery and visual rehabilitation should be undertaken as early in life as is medically feasible.
A child’s first comprehensive eye examination should take place at 6 months of age. The American Optometric Association Foundation’s InfantSEE® program provides a comprehensive infant eye assessment within the first year of life as a no-cost public health service.