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Every Child Needs One

Today’s guest blogger is Dr. Ida Chung.  Dr. Chung is currently the president of the College of Optometrists in Vision Development (COVD).  She is also the Director of Optometric Education at Western University College of Optometry. 

young girl making facesCOVD has always been on the right track when it comes to what is best for children’s vision: every child needs a comprehensive vision examination. Only a thorough vision examination will evaluate all the skills needed for academic success— not only acuity and eye health, but also focusing, eye teaming, eye tracking, and visual processing skills.

A group of multidisciplinary pediatric vision and eye health experts recently published three articles on best practices for vision screenings. Vision screenings in young children (36-72 months old) focus on the detection of amblyopia and strabismus, which are the most common visual disorders in preschool children. The articles focus on best practices for vision screenings, because if you are going to perform a vision screening, you want to increase the likelihood of detecting undiagnosed amblyopia and strabismus; but increasing the likelihood of detecting an undiagnosed vision problem is not good enough. Despite “best practices”, many children with vision problems will still pass the vision screenings. The combination of low sensitivity and selective testing adds up to undetected vision disorders, and delays in diagnosis and treatment.

The expert panel acknowledges that certain children require an automatic referral for a comprehensive examinations because of the increased risk for visual disorders—children with known neurodevelopmental disorders (e.g., hearing impairment, motor abnormalities such as cerebral palsy, Down syndrome, cognitive impairment, autism spectrum disorders, or speech delay); children with systemic diseases or using medications known to cause eye disorders; those with a family history of a first-degree relative with strabismus or amblyopia, and children born prematurely at less than 32 completed weeks of gestation.

Why not offer this same opportunity to all children?Any child with an undetected vision problem is at increased risk for academic difficulties and decreased quality of life.

No best practice for vision screenings will come close to providing children with the vision care they need to be sure they possess all the visual skills needed for academic success. Excellent vision starts with seeing clearly but it doesn’t end there. Focusing skills and eye teaming skills are equally important for school readiness and academic success.

How many children currently receive vision screenings? Existing national estimates suggest a range between a low of 2% to a high of 64%. And how many fail the screening? And how many receive comprehensive vision care after failing the screening? There are so many weak links in the vision screening pipeline. Let us focus on ensuring children obtain the vision care they need. Let us be leaders in vision care for children and continue to advocate for comprehensive vision exams for every child because a comprehensive eye examination is essential to diagnose and make the appropriate treatment recommendations. For the past 43 years COVD members have always focused on what is best for children’s vision, and we will continue to do so.

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