Screening of Childrens Eyes

In an ideal world, all children's eyes would be examined at birth by a specialist and again at six months to exclude congenital abnormalities and amblyopia. This is rarely achieved, although most children in the UK are examined by a nonspe-cialist at these points. Most children are also screened routinely in school at the age of six years, and any with suspected poor vision are referred for more detailed examination. A further examination is often conducted at the age of nine or ten years and again in the early teens. The commonest defect to be found is refractive error,that is simply a need for glasses without any other problem. The ophthalmological screening is usually performed by a health visitor in the preschool years and a school nurse for older children. Screening tends to include measurement of visual acuity alone but checking any available family history of eye problems would be helpful. When there is a difference in the visual acuity of each eye, the screener should suspect the possibility of a treatable medical condition rather than just a refractive error. A test of colour vision should also be included in the screening programme for older children and this can be conveniently done using the Ishihara plates. It is worth remembering that colour blindness affects 8% of men and 0.4% of women and it might have important implications on the choice of a job. It is also equally important to realise that colour blindness can vary considerably in degree and can often be so mild as to cause only minimal inconvenience to the sufferer.

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