Some parents first learn their children have vision problems after they start attending school, when the teacher sends home a note saying little Johnny is having trouble seeing the blackboard. Up to 10 percent of pre-school children have vision problems, many of which can be corrected if caught early enough through vision testing and screening. The American Academy of Pediatrics advocates childhood vision screenings begin as early as the newborn period.
The American Academy of Family PhysicianS estimates that between 5 and 10 percent of all young children have some type of vision problem including strabismus, the misalignment of the visual axis that can lead to amblyopia, the primary cause of monocular vision loss in adults. Undetected vision problems in children can lead to loss of vision, decreases in academic performance and even psychological challenges, according to the AAFP.
The American Academy of Pediatrics recommends that primary care physicians perform an ocular structure examination on newborn infants to check for abnormalities. All subsequent well-child checkups should include an assessment of the eyes. Vision assessments in children age three and under should include tests that measure the child’s ability to fix their gaze on an object and follow it with their eyes. Assessments for children over the age of three may include picture cards and charts. Children who are familiar with their numbers and letters and who are verbal may use eye charts that feature Snellen letters and numbers.
A number of different types of vision tests are appropriate for children. Photoscreening is a photographic technique that can reveal the presence of ocular conditions as strabismus, retinal and refractive abnormalities and cataracts. Motility tests such as the corneal reflex test and random dot E stereo test can help diagnose ocular alignment problems in young children. Physical examinations check the external aspects of the eyes including the eyelids, iris, cornea and pupil for deformity or damage.
Doctors typically ask the parent about their child’s general well being, including any observations about vision issues the child may not be aware of. Parents should note and report observations of misaligned eyes, a wandering eye, a child who tends to tilt her head when trying to focus on an object or frequently rubs her eyes. Other signs of vision problems may include covering one eye while concentrating on an object, frequent squinting or complaints that things are fuzzy or blurry. Parents should also volunteer information regarding any family history of visual disorders.
Vision testing in children under the age of five can result in significant health improvements, according to the U.S. Preventive Services Task Force. Early screening may identify and reduce the prevalence of childhood and long-term amblyopia. Early screening has also been shown to accurately identify other vision disorders such as strabismus and refractive errors. Identification and treatment of these conditions can lead to improved visual acuity.