School Vision Screenings

myopia

School Vision Screenings

Background

Approximately one in five Australian children suffers from an undetected vision problem, or requires ongoing assessment[1]. Therefore, a school vision screening can help to uncover a child’s vision problem.

Medicare statistics

Medicare statistics show an alarming decline in the number of Children’s Vision Assessments per capita in the 0-4 year old group over the past 3 years. Most noteworthy, this trend appears to extending into the 5-14 year age group[2].

Important eye conditions

Early detection is essential to potentially overcoming any long term vision deficiencies. The three most common children’s eye conditions which require early diagnosis are binocular vision problems, amblyopia and refractive error.

1. Binocular vision

Alignment of the eyes during the early years of life is considered critical for development of binocular vision[3].

2. Amblyopia (lazy eye)

Amblyopia is a condition that occurs when there is altered visual input or abnormal binocular interaction resulting in diminished vision in one or both eyes[4]. The term used to describe any anomaly of ocular alignment is strabismus. Strabismus is also the most common cause of amblyopia. Also, it can occur in one or both eyes and in any direction[5].

Amblyopia is unique to children but is preventable if the child receives adequate treatment in childhood. The prevalence of amblyopia is approximately 1% – 4% of preschool children[2]. The Lea Symbols Chart has been shown to have a high sensitivity for amblyopia[6].

3. Refractive error

Short sightedness and long sightedness result in a child not being able to perform visual tasks to their maximum ability. Furthermore, refractive error is easily corrected. A child doesn’t necessarily need to wear glasses all the time.

Why is an eye test for kids important?

Vision development is thought to be complete by the time the child is eight years of age, however some aspects of visual development will already be complete by the time the child reaches school age[7].

Recommendation for kids eye tests

The National children’s vision screening project[8] conducted in 2008, recommended that a vision screen should be conducted for all children at around 4 years of age, with an allowable range from 3.5 to 5 years. Using the 15 line (3 metre) Lea Symbols Chart achieves this in the community health setting. The Lea Symbols Chart distance visual acuity test has been shown to be successfully used in 76% of children 3 years and over and more than 90% of children 4 years and over[4].

Optometry Australia recommends that children have a full eye examination with an optometrist before starting school and regularly as they progress through primary and secondary school[9].

It is important that all children receive a vision screen prior to school entry to:

  1. Identify eye and vision problems that may cause permanent vision loss;
  2. Identify eye and vision problems that can affect a child’s learning;
  3. Maximise treatment outcomes by identifying and treating childhood vision problems early, during the critical visual development period;
  4. Prevent avoidable vision loss and/or blindness later in life.

While eye health surveillance by family members and teachers can monitor a child for outward signs of eye or vision problems, the two most common childhood vision problems, amblyopia and refractive error, cannot be detected by family history, vision surveillance or observing a child’s behaviour or appearance. So, a trained vision screener or qualified eye health professional can only be detect these common childhood vision problems with a monocular visual acuity screen.

Noosa school vision screening

Noosa Optical offers a free, community school vision screening program. We offer this through participating kindergarten and primary schools in the Noosa area.  The program is based upon peer reviewed standards and is free for children in kindergarten, prep and junior school age groups. We aim to assist parents, guardians and teachers in identifying amblyopia and refractive errors in young children using a specially designed test for young children.

It is important for us to look after our children’s vision. We’re well qualified to help and support our local community. So if you would like to participate in the program, please contact us or ask your school.

References:

[1] Optometry Australia Children’s Vision Resources; http://www.optometry.org.au/

[2] http://medicarestatistics.humanservices.gov.au

[3] Duckman R H. Visual Development, Diagnosis, and Treatment of the Pediatric Patient. Lippincott Williams and Wilkins. Philadelphia, USA, 2006: 279-280.

[4] Granet D. Amblyopia and Strabismus. Pediatric Annals. 2011 Feb 40 ;(2): 89-94.

[5] Coats  D  K,  Paysse,  E  A.  Evaluation  and  management  of  strabismus  in children. In: UpToDate, Basow, DS (Ed), UpToDate, Waltham, MA, 2012.

[6] Becker R, Hubsch MH, Graf MH, Kaufmann H. Examination of young children with Lea symbols. British Journal of Ophthalmology 2002; 86: 513-516.

[7] NSW   Government.  Statewide  Eyesight  Preschooler  Screening  (StEPS) Program. Ministry of Health, NSW. Jan 2012. p. 1.

[8] Commonwealth of Australia. National children’s vision screening project. Murdoch Children’s Research Institute. Oct 2008.[9] http://www.optometry.org.au

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