Through a Child’s Eyes, Part 2

Last week, I blogged about some common vision problems diagnosed in children and the importance of early detection through vision testing (click here for that post). Today’s post gives more details of the vision screening process.

Impaired vision in children can seriously affect learning abilities and contribute to the development of behavior problems. Early discovery and treatment can prevent many of these problems. Children with vision problems are often not aware of their difficulty, nor do they complain or seek help. The purpose of a vision screening is to identify those children who should be further examined by a doctor of optometry for potential problems and possible treatment.

A thorough vision-screening program will evaluate six areas of vision:

1. ACUITY - the ability of the eye to see clearly in the distance and at near

• Near Vision - the ability to see at 8 inches to 10 inches (i.e., to read a book)
• Intermediate Vision - the ability to see at 16 inches to 40 inches (i.e., to use a computer)
• Distance Vision - the ability to see at 10 feet or more (i.e., to read a chalkboard)

2. EYE MUSCLE COORDINATION - ability to maintain a single image through fusion, during convergence and eye movement, without deviation or tendency for deviation

• Binocular Fusion - the ability to coordinate and align both eyes to allow the brain to fuse a single image from the images it receives from each eye
• Stereopsis (binocular depth perception) - the ability to judge relative distances of objects to see and move in a three-dimensional space
• Eye Movement - the ability to move the eyes from one point to another
• Convergence - the ability to turn the two eyes toward each other to focus on a close object

3. REFRACTIVE ERROR - the inability of the eye to focus light upon the retina. Common refractive errors include nearsightedness, farsightedness and astigmatism

4. EYE HEALTH - the absence of anomaly or disease

5. COLOR VISION – the ability to distinguish colors

6. ACCOMMODATION – the ability to change/maintain focus at different distances.

General Information about Vision and Screenings

— Refractive errors are found in 15 percent of the student population and account for 50 percent of detectable eye defects.

— Refractive errors increase with age, requiring screenings to continue throughout the school age years.

— Strabismus affects two percent of the preschool population. Early detection is essential for effective treatment.

— Amblyopia is the decrease of visual acuity in one eye. The most frequent cause of amblyopia is strabismus. The only prevention is early detection and treatment. Since the most effective treatments must be started before age six or seven, identification of this condition at the earliest possible age is crucial.

— Color deficiency is a reduced ability to recognize the differences in color, especially red and green. Eight to ten percent of males and .04 percent of females are affected. Total absence of color discrimination is present in only a very small percentage of males and almost never in females. Because color deficiency may hamper a child’s ability to participate in lessons that require color identification and, left untreated, can ultimately limit the student’s career choices, it is important to identify deficiencies at an early age.

— Other eye conditions, which can be detected during school screenings, include eyelid abnormalities (for example, ptosis), congenital defects, and systemic eye disease with eye-related associations.

National studies have shown that 20-25% of children ages 5-14 have vision problems that require further professional eye care. This ratio increases to over 30% for the 15-19 age group. The American Optometric Association and the American Academy of Ophthalmology recommend that all children should undergo an evaluation to detect eye and vision abnormalities during the first few months of life and again at about age three. However, 62 percent of mothers of pre-school children report that their children have never had a thorough eye examination and less than 20 percent are aware that eye problems in preschoolers, if not diagnosed and treated early, could lead to vision problems.

(Excerpted from “A School Nurse’s Guide to Vision Screening” by the American Optometric Association, based on “The Nurse’s Guide” that was originally published and distributed by the American Foundation for Vision Awareness)

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We’re heading to the AAPOS annual meeting in San Antonio tomorrow. Stop by our booth and see a demo of our Smart System PC-Plus for the Pediatric Eye Care Professional.

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