Many Blinding Childhood Eye Disorders Have No Warning Signs

Sight Can Be Saved Through Vision Screenings

WASHINGTON - When four-month old Baxter's pediatrician performed a vision screening she got an abnormal reading on the test and referred him to a pediatric ophthalmologist.

It was discovered that Baxter had cataracts in both eyes, a fact that completely surprised his parents as they had no idea that cataracts could develop in young healthy children.

At four months old, Baxter could not communicate to his parents that his world was hazy and that he couldn't see the pictures in the books his parents read to him at night. Baxter promptly underwent surgery to remove the cloudy lenses and replace them with artificial ones.

Thanks to early detection by his pediatrician, permanent vision loss was avoided and sight was restored. Now Baxter enjoys the stories his parents read to him, and the pictures, which he can see clearly, are his favorite part.

"The good news is that with early detection through a vision screening and subsequent treatment, most children can have improved vision and avoid blindness," said pediatric ophthalmologist Christie Morse, MD, president of the American Association for Pediatric Ophthalmology and Strabismus. "The bad news is that only one in five preschoolers are having their vision screened."

According to the National Eye Institute, an estimated 300,000 to 750,000 children aged 3 to 5 have amblyopia (lazy eye), and 450,000 to 600,000 have strabismus (eye misalignment). An estimated 1.5 million to 2.3 million have a significant refractive error (poor vision that can be corrected with glasses or contact lenses).

Ophthalmologists believe part of the problem is that parents are under the misconception that vision disorders will show themselves when children start to school through problems with reading or meeting academic benchmarks. NEI data shows 2.3 million, or 15 percent, of children have undiagnosed eye disorders that can lead to blindness if left untreated. Most of these disorders do not have warning signs and can only be detected by a vision screening.

Some of these common eye disorders include:

Amblyopia--straight-eyed children can suffer from amblyopia, which results in reduced vision in the affected eye. Because vision in the good eye is not altered, often this problem is not detected. If left untreated, the result can be permanent blindness in the poor eye. If detected early, the child can be treated with eye glasses, patching or medicated drops, which results in excellent vision for most patients.
Cataracts--there is a misconception that only senior citizens get cataracts, but children, even infants, can get them. Cataracts cause the ocular lens to cloud, impairing sight. Surgery removes the cloudy lens of the eye and replaces it with an artificial one. Vision can be restored with surgery and follow-up treatment. Without treatment, a child with a cataract would be legally blind in the affected eye.

Strabismus--children with strabismus have misaligned eyes that may be subtle enough to go undetected by the parents. The result is that the child has no depth perception, which can make some day-to-day activities difficult. Without treatment, the child is likely to lose vision in one eye, which is called amblyopia. The initial treatment is eyeglasses and possible surgery on the eye muscles. With this treatment, the child can have good vision restored.

Extreme farsightedness--this condition results in a child being unable to see well at any distance. Without treatment, vision may be irrevocably lost. Eyeglasses are used to improve the child's vision and stop the loss of sight.

"Parents are the first line of defense for children's vision health because young kids often can't communicate that they're having a problem seeing," said Michael Repka, MD, American Academy of Ophthalmology secretary for Federal Affairs and professor of ophthalmology and pediatrics at Johns Hopkins University. "Vision screenings are safe, inexpensive, effective and smart; they catch problems this year that weren't there last year. Screenings can take place as part of well-child exams, in schools, and can be performed by pediatricians, family physicians, nurses, and lay screeners."

Ophthalmologists are M.D.s who specialize in comprehensive eye health and they strongly support routine vision screenings.

Children not covered for this service can find complimentary screenings through Prevent Blindness America or their local health departments.

The American Academy of Ophthalmology and the American Association for Pediatric Ophthalmology and Strabismus support serial children's vision screenings.

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