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 For kids around preschool age, vision screening can help identify
risk factors or symptoms of what’s known as amblyopia, or lazy eye,
which can lead to permanent vision loss, according to the guidelines
issued by the government-backed U.S. Preventive Services Task Force
(USPSTF).
“Vision screening of children ages three to five in the primary care
practice setting can detect amblyopia, also known as lazy eye, or
other conditions that if untreated could lead to amblyopia,” said
task force member Dr. Alex Kemper of Nationwide Children’s Hospital
in Columbus, Ohio.
“Scientific evidence shows that this can lead to better vision,”
Kemper said by email. “For children younger than three, more
information is needed about the accuracy of vision screening tests
in the primary care setting and the effectiveness of detecting
problems in younger children compared to those who are three or
older.”
Lazy eye, one of the most common vision problems in children,
involves an alteration in the visual neural pathway in a child’s
developing brain that can lead to permanent vision loss in the
affected eye.
About 1 percent to 6 percent of children under age 6 have amblyopia
or risk factors for it, such as eyes that point in different
directions or unequal focusing abilities in each eye, the task force
notes in guidelines published in JAMA.
Early detection of risk factors for lazy eye can lead to
improvements in the ability to focus, the guidelines note.
Treatment is more effective at younger ages, and untreated lazy eye
can lead to lasting physical or psychological difficulties,
accidents and injuries, poor visual motor skills, and problems with
school and work. Treatment can include glasses, often paired with an
eye patch.
One challenge in testing children under 3 is that these kids may not
be able to reliably articulate what they see during exams, said Dr.
William Good, a scientist at the Smith-Kettlewell Eye Research
Institute in San Francisco whose editorial on the study was
published in JAMA Pediatrics.
“Children older than 3 usually can offer verbal responses to
questions about what they see,” Good said by email. “Under 3 years
we often can’t rely on feedback from children, a roadblock to
learning whether interventions matter for this younger age group.”
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The current guidelines apply only to screening of children without
symptoms of vision issues.
Even before age 3, kids should have a vision exam if they appear to
have issues such as squinting at objects in the distance or
consistently closing one eye when they look at things, doctors say.
Parents should also tell pediatricians if there’s a family history
of vision problems at a young age.
Currently, only about half of kids who should get vision screening
are receiving these exams, said Dr. Sean Donahue, author of an
editorial in JAMA Ophthalmology and head of pediatric ophthalmology
at Vanderbilt University Medical Center in Nashville, Tennessee.
“Vision screening is important to detect problems that cause
amblyopia, which is when an eye gets shut off by the brain, usually
because it is misaligned or because of an asymmetric need for
glasses between the eyes,” Donahue said by email. “New technologies
have allowed earlier detection of these problems, prior to when a
child is able to read the eye chart.”
SOURCES:
http://bit.ly/2xP8a4i JAMA, online September 5, 2017.
http://bit.ly/2xPmVUL JAMA Pediatrics, online September 5, 2017.
http://bit.ly/2eM8WL0 JAMA Ophthalmology, online September 5, 2017.
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