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1、VisionScreeningWhydoweScreen?·Prevalenceofundetectedvisionproblemsinpreschoolchildrenisestimatedtobe5-10%o3%haveamblyopia(Developedbewtweeninfancy–7years)o2-4%havestrabismus·Visualmaturationuntil7-10yrsthenlosesightpotential·20%ofchildrendeveloprefractiveerrorsthatrequireglas
2、sbeforelateadolescence·EarlydetectionisimportanttoavoidlifelongvisualimpairmentWhendowescreen?·AmericanAcademyofPediatricsrecommendsexaminationoftheeyesatallwellchildvisits.·USPSTF(USPreventitveServicesTaskForce)&AAPrecommendscreeningtodetectamblyopia,strabismus,anddefectsinv
3、isualacuityyearlyinchildrenyoungerthan5years.o0-3y/o:fix&follow,redreflex,corneallighto3+y/o:measurevisualacuity·AmericanAcademyofPediatricsCommitteeonPractice&AmbulatoryMedicine,AmericanAssociationforPediatricOphthalmology&Strabismus,&AmericanAcademyofOphthalmologyrecommenda
4、geappropriatevisualscreeningatleastat5y/o,6y/o,8y/o,10y/o,andonceduringtheperiodsofearly(12y/o),middle(15y/o),andlateadolescence(18y/o).History:·Doesyourchildseemtoseewell?·Doesyourchildholdobjectsclosetohis/herfacewhentryingtofocus?·Doesyourchildsquint?·Doyourchild’seyesappe
5、arstraightordotheyseemtocross,driftorappearunusual?·Doyourchild’seyelidsdroopordoesoneeyelidtendtoclose?·Haveyourchild’seyeseverbeeninjured?Waschildpremature?6FamilyHistory:·Cataracts,retinoblastoma,strabismus,amblyopia,nystagmus,glaucomaoFhxofretinoblastomas,cataracts,glauco
6、ma,andretinalabnormalitiesshouldbereferredtoanophthalmologistregardlessofyourexamination(RedReflexAAPpolicy2008-attached).·Eyedisorders,preschoolorearlychildhooduseofglassesinparentsorsiblings·Historyofcertainmetabolic&geneticdiseaseMethodsofEvaluation:·VisualAcuitytests:oSne
7、lleneyechart(letters,numbers)oLeafigurechartsoTumblingEoHOTVoAllenfigures·OcularAlignmenttests:oFixationReflex:Startingat2monthsaninfantshouldfixandfollowpastmidline.Verticaleyemovementsdevelopby3months.EOMshouldbetestedateveryWCC.oCornealLightreflex:standingafewfeetbackfromc
8、hild.Shinealightintobotheyesatsametime.Thelightreflectionshouldequal
