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Vision Screening for Children

young girl in a physician's exam room

The eyes provide a window into the overall health of patients conditions can be diagnosed earlier and more easily with something as simple as a routine eye exam.1 This extends to children, who have much more to lose if eye-related conditions remain undiagnosed and untreated.

In fact, the National Eye Institute estimates that amblyopia—a condition often referred to as “lazy eye”—affects up to 3% of children in the United States.2 When left untreated, amblyopia can cause severe visual disability, including significant visual impairment, vision loss and even legal blindness. With early diagnosis, physicians can prevent these outcomes entirely, but only when eye exams are performed early and often.

Below are key take-aways regarding pediatric vision screening from Dr. Melissa Wong, a board-certified ophthalmologist and a fellowship-trained pediatric ophthalmologist and adult strabismologist. When she stresses the importance of early intervention for pediatric vision issues, it’s because it affects real lives.

Here’s what pediatric clinicians and physicians should know about eye exams for children, according to insights from Dr. Wong.

1. Vision screening performed early and often is vital for the detection and diagnosis of pediatric amblyopia.

“The repercussions of undertreated or untreated amblyopia are very far-reaching, and screening is vital because many of the causes of amblyopia are invisible even to the most vigilant primary care physicians [and] parents,” says Dr. Wong.

What should physicians look for in order to spot amblyopia? Symptoms to look for include:

  • Significant refractive error
  • Strabismus
  • Anisometropia

These risk factors can be detected in a number of ways, including with a clinical exam at the well-child check, with a chart-based visual acuity test, and with photoscreeners or autorefractors.

Dr. Wong says the benefit of using autorefractors or photoscreeners in a child’s eye exam is that screening can take place much younger than with other tests. Specifically, the American Academy of Ophthalmology recommends vision screening for children as early as 12 months.2 Dr. Wong also notes that instrument-based vision screening may be beneficial for children with developmental disabilities who are unable to read a visual acuity chart.

“Pediatric ophthalmology treatment ranges from eyeglasses, patches, drops to even surgery,” Dr. Wong said. “These treatments can be very effective if we’ve not missed that critical period of vision development. Family medicine physicians and pediatricians are at the forefront of detection, and no child is too young or too difficult.”

2. Vision screening can be easily incorporated into your practice.

One of the major benefits of instrument-based vision screening is that it can be easily included in any clinician’s practice. The tools needed are minimal and the skillset to use a photoscreener or autorefractor is quick to acquire.

“Instrument-based vision screening can be very easily integrated into your clinic workflow. All you really need is the photoscreener or autorefractor and a dimly lit room,” says Dr. Wong. “It can take seconds to minutes—it takes away the need for you or your medical assistant [to check] to see if a child is peeking around the occluder, if they really understand what you’re asking them to do, or if they just simply memorized all the symbols on the chart.”

In addition, Dr. Wong says a layperson can be taught to use an instrument-based vision screener, making it ideal not just for pediatricians, but other qualified individuals.

Although photoscreeners and autorefractors are vital for early detection, Dr. Wong did warn that some patients may need to be referred to pediatric ophthalmologists. Young patients with a family history of vision problems, or children who cannot successfully complete an instrument-based vision screening should see a specialist for a full eye exam with dilation, according to Dr. Wong.

3. Vision screening can help have a significant impact on patient outcomes.

Instrument-based vision screening is simple, reimbursable and crucial for early detection of vision impairment—but it also can have real impact on patients, Dr. Wong stresses.

“The goal of having all these tools to screen is to increase access to screening so we can [diagnose] more children earlier and successfully manage their amblyopia,” Dr. Wong says.

Dr. Wong stressed that early detection leads to more effective treatment, which can save a child’s vision as they move into adulthood.

Help to Achieve Better Patient Outcomes with Instrument-Based Vision Screening

Instrument-based vision screening provides an opportunity for all children to be screened during regular check-ups with their pediatrician. As a result, more children will be referred to eye doctors during the early stages of amblyopia and other vision disorders, shifting the care delivery to a preventative stage and thus helping to reduce vision loss in children.

Learn more about the importance of instrument-based vision screening by downloading our eBook, Save Sight in Children.

References

1. Cleveland Clinic. Your Eyes: A Window to Your Health. https://health.clevelandclinic.org/your-eyes-a-window-to-your-health. Accessed November 1, 2024.

2. National Eye Institute. Amblyopia (Lazy Eye) | National Eye Institute. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/amblyopia-lazy-eye. Accessed November 1, 2024.

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US-FLC158-240144 (v1.0) 11/2024