Introduction

Many cases of blindness in India are preventable and treatable if identified at an early stage. Children are most vulnerable to ocular disorders due to their inability to provide information about vision changes. Thus, it is important that the vision screening of children should be done routinely to diagnose the condition as early as possible.

Why Vision Screening Should Be Performed?

There are approximately 18 million visually impaired children in the world. In India, the number of visually blind children is 1.4 million. A large number of children in India are at risk of being blind. Fortunately, more than half of the cases are preventable or treatable. Thus, it is important to screen the vision of children routinely.

Types Of Vision Screening

Following are the types of vision screening

Subjective Screening

Subjective screening is usually done in children above the age of 5 years. This screening requires the active participation of the children. The child may be asked to identify the shapes and letters. Acuity measurement is done by using an appropriate eye chart.

Objective Screening

Objective screening is done in younger children. The device is used to analyze the eyes and taking measurements. Objective screening is done through the following methods

Autorefractive screening: Faster than the acuity test, this screening is done to identify the risk of amblyopia. However, this may not be appropriate for analyzing strabismus.

Photo-screening: As this process is performed binocularly, this method may also be used to identify strabismus. This method may also be used to identify various other ocular conditions such as ptosis, coloboma, or cataract.

Who Can Perform Vision Screening?

Although the vision screening can be performed best by an ophthalmologist, however, following healthcare professionals may also be able to undertake vision screening in children:

• Family physician

• Pediatrician,

• Healthcare provider properly trained in performing pediatric vision screening

When And How Vision Screening To Be Performed?

The American Association for Paediatric Ophthalmology and Strabismus and The American Academy of Ophthalmology recommended vision screening as per the following schedule:

New Born

The eyes of the newborn ae screened for any birth disorders of the eye. The normal eye indicators are tested. The testing includes a “red reflex” test and Blink and pupil response.

6 months to 12 months

It is more detailed testing done in the first year of life. The ophthalmologists perform a “red reflex” test and blink and pupil response. The additional tests include visual inspection of the eyes and checking for any ocular misalignment and abnormal eye movement.

12 months to 36 months

In this screening, the ophthalmologist will check the healthy development of eyes. During this screening, objective testing like a photo-screening may be performed to determine amblyopia.

3-5 years

At this screening, the refractive errors in the child are identified. The doctor may check for any focussing problem along with the presence of amblyopia, astigmatism, and strabismus.

Above 5-years

This screening can be done through objective assessment. The most common problem identified during this screening is myopia.

Difference Between Vision Screening And Detailed Eye Examination

There is a difference between a vision screening and a detailed ocular examination. While the vision screening only identifies that there is some problem in the eyes, the comprehensive eye examination identifies in detail the eye problems and risk associated though advanced testing procedures. If a child fails in the vision screening or the vision screening cannot be done, or the child is at risk of developing an ocular condition, a comprehensive eye examination is advised.

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