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[Early diagnosis of vision disorders].

In recent years some pilot-studies were performed at health centres in Amsterdam, on infants of 8-9 months of age, concerning early detection of visual disorders. The method consisted of a programme of corneal light reflexes, cover test, monocular following movements and inspection of the cornea, the pupil and the pupillary reaction. The aim of the studies was: 1. Is this programme efficient for early detection of organic eye disorders and strabismus at this age? 2. Is the method reliable, if performed by doctors of the health centres? The results of the studies were positive. In at least 1,9% of the 1200 children of the pilot-study a visual disorder was detected. The method can be incorporated in the regular working scheme of the health centres and can be performed on infants from the age of 6 1/2 months.

Age Factors↗

[Childhood vision disorders. Screening programs in international comparison].

Worldwide in a number of countries, screening programs aimed at detecting visual disorders in children are established. Repeatedly, proposals are brought forward to optimize already existing programs. Countries without such a program are interested in learning about current models as a guide for planning their own program. This study was performed to take stock of the screening programs for visual dysfunction in children in existence in the years 1999-2000 worldwide. The aspects considered were the child's age at examination, examiner's qualification, type of examinations performed, cost-bearing entity, and cost-efficacy analysis. The health ministries of 190 sovereign countries were asked via a questionnaire for information about possibly existing screening programs. The results of the survey were analyzed quantitatively regarding geographic, political, and socioeconomic aspects, yielding data for the exchange of experience in optimizing existing programs and developing new programs.

Child↗

[Screening of vision disorders in young children].

Twenty pediatricians conducted a study for the detection of ophtalmological defects in children aged 36 to 54 months using a protocol designed by the Groupe Romand d'Etudes en Pédiatrie Ambulatoire (GREPA) and by an ophthalmologist. After a pilot test run for correcting the protocol and the testing procedure, visual acuity was assessed using the Scholatest, stereoscopy using the Lang test and ocular deviation using the Hirschberg test. A total number of 1243 children were examined, some of which needed to be tested twice. The visual acuity assessment provided an abnormal result in 241/1387 tests (17.4%); stereoscopy defects were detected in 39/1371 tests (2.8%) and strabismus in 41/1446 tests (5.7%). The test system allowed for detection of ophtalmological abnormalities in 14.7% of all children. This first Swiss study on detection of ophtalmological defects in preschool age children has established the feasibility of the testing procedure in ambulatory pediatrics during a routine examination. This procedure allows earlier detection of defects as well as earlier treatment with a better outcome. Early detection of ophtalmological defects has obvious Public Health implications.

Child, Preschool↗