Vision Screening and Eye Examination in Children

Vision screening and eye examination are important for the detection of conditions that distort or suppress the normal visual image and, ultimately, may lead to blindness in children. Examination of the eyes can and should be performed at any age, beginning in the newborn period. Vision screening should be performed at as early an age as is practicable. Conditions that interfere with vision are of grave import because visual stimuli are critical to the development of normal vision. Decreased visual acuity often contributes to inadequate school performance. In addition, retinal abnormalities, cataract, glaucoma, retinoblastoma, eye muscle imbalance, and systemic disease with ocular manifestations may all be identified by careful examination. Vision screening should be carried out as part of a regular plan of continuing care, beginning in the preschool years. Screening examinations may be effectively performed by paramedical personnel under appropriate medical supervision. As with other specialty areas, it is important for the pediatrician to establish contact with an area ophthalmologist in the same geographical area who is familiar with children's eye problems. A close working relationship with such a specialist will clarify questions about procedures for eye screening as well as indications for referral. TIMING OF EXAMINATION AND SCREENING Children should have age-appropriate assessment for eye problems in the newborn period and at subsequent health supervision visits. Vision screening can begin as early as 3 years of age. Infants at risk for eye problems, such as retrolental fibroplasia, or those with a family history of congenital cataracts, retinoblastoma, and metabolic and genetic diseases should have an ophthalmologic examination in the nursery.