FRIDAY, March 8, 2002 (HealthDayNews) -- Diagnosing vision problems in children is never easy, and doing so in babies or toddlers is especially difficult. So many parents don't even contemplate an eye exam until a child reaches school age.
That can be a big mistake, doctors say.
A new report in the March issue of Pediatrics says many devastating eye diseases can begin in infancy or early childhood -- problems that, if diagnosed sooner rather than later, could mean the difference between sight and blindness.
Moreover, experts say, a relatively new screening system can find these conditions quickly without forcing the child to do anything more than say "cheese."
"Each year, it is estimated that thousands of children suffer permanent eye damage simply because they have not had their vision screened early enough to catch problems when they can still be easily treated," says Dr. Allan M. Eisenbaum, a contributor to the report and an associate professor of ophthalmology at the University of Colorado Health Sciences Center.
Problems that can rob an infant's eyesight, Eisenbaum says, include cloudings of the eye lens such as infant cataracts, eye muscle disorders known as strabismus, and refractive errors that can affect focusing. Another problem, known as amblyopia -- sometimes called "lazy eye" -- can cause permanent vision damage if not caught and corrected early.
Unfortunately, Dr. Robert Cykiert says, infants and young children can't tell you they can't see -- or even indicate something is wrong.
"A child who has problems from birth won't know how things are supposed to look, so even if they can talk, they have no point of reference from which to know something is wrong," says Cykiert, an associate professor of ophthalmology at New York University School of Medicine.
And, he says, even if children recognize they have a problem seeing, they may not be able to communicate that fact easily to parents. The new report suggests infant and toddler vision screening and, specifically, the use of photoscreening.
Photoscreening is an optical system that requires nothing more than the child looking into the lens of a camera for a few seconds. The resulting photo, which documents the amount of light bouncing off the retina, can find numerous vision problems.
"Photoscreening is not a single technique or a single piece of equipment, but rather a system that uses the picture of a child's eye to indicate potential vision problems," says Dr. Jack T. Swanson, chairman of the American Academy of Pediatrics' (AAP) Committee on Practice and Ambulatory Medicine and co-author of the new report.
The photos, which look much like Polaroids, are "read" by trained professionals, who look for early signs of vision problems.
Photoscreening can identify problems associated with cataracts, astigmatism (a defect in the refractive part of the lens which prevents you from seeing sharp images), anisometropia (a refractive error that affects focusing), strabismus (a misalignment of the eyes), and both nearsightedness and farsightedness, Eisenbaum says.
If problems are discovered during the screening, a trip to the ophthalmologist can yield a more definitive diagnosis and a treatment plan. This can include glasses, eye exercises or sometimes surgery.
While the AAP endorses the use of photoscreening, it also cautions parents that not all photoscreenings are equal. The success of the test often hinges on the expertise of the technician "reading" the pictures.
"The reader must understand the limitations of the test, and be familiar with the rate of false positives and false negatives within the screening population, in order to get the most reliable screening results," Swanson says. If your child receives a "questionable" report -- meaning it is not negative or positive, the test should be repeated.
In addition to photoscreening, AAP also encourages more research on the system itself.
Both Swanson and Eisenbaum emphasize, however, that photoscreening does have value right now. The AAP urges all parents to have their children's eyes screened beginning as early as 6 months of age, and to continue testing regularly throughout their growing years.
Currently, studies show that one in 20 children have vision problems before they are school-aged. Experts say that figure could rise as more children are screened.
What To Do
If photoscreening is not available through a clinic or community program in your area, the AAP suggests talking to your child's pediatrician and specifically requesting a vision screening.
To learn more about eye problems in infants, visit All About Vision. To find information on eye problems in toddlers and preschoolers, click here.
For a good overview of children's vision problems, visit Children's Vision Information Network.
