VISION SCREENING OF PRESCHOOL CHILDREN

Ideally, an eye examination should be performed immediately after birth and periodically during the preschool years. These years are important because it is at this time that much of a child's relationship to his environment is being established through visual channels and treatment for visual disorders is most successful. At present, this is an impossible goal due to the large reservoir of preschool children, limited trained personnel and financial support, and lack of understanding by the publie of the importance of early eye care. As an interim measure, the most practical approach seems to be one of vision screening as part of the total health supervision of the preschool child. This would encompass children from 3 to 5 years of age and could be performed by trained paramedical personnel or volunteers with a minimum of equipment. For a successful program there must be community cooperation, approval, organization, education, and financing. A real effort must be made to contact that large group of children who are unknown to any service (physician) or agency. The screening itself has little value unless it is accompanied by adequate follow-up and resources to accept the referral and supervise the provision of proper care. CONDITIONS DETECTED BY SCREENING 1. Refractive errors. 2. Muscle imbalance. 3. Amblyopia. 4. Some eye diseases. SCREENING PROCEDURES A. Observation or history-applicable from birth. 1. Unusually large eyes, sensitivity to light, excessive tearing, cloudiness, inflammation, hemorrhage, abnormal eye movements, i.e., nystagmus. 2. Difficulty with focusing or persistent deviation of one eye after 6 months of age.