Vision Screening and Ocular Examination
Appropriate vision screening is one of the most important factors in pediatric eye care. Because focused visual stimuli are critical to normal development, early detection and correction of visual problems reduce serious vision impairment or blindness. In particular, vision screening is needed to detect four major conditions—strabismus, amblyopia, ocular disease, and refractive errors.
Amblyopia & Strabismus
Amblyopia and strabismus are two distinct diseases that might be associated. Children can have amblyopia without having a strabismus. The proper corrective treatment for strabismus includes nonsurgical treatment, such as patching and glasses, and surgical treatment, when indicated. Eye muscle surgery is performed when it is clear that nonsurgical methods may not correct the misalignment, the misalignment is worsening despite treatment, or there is progressive loss of fusion. Four aspects of strabismus surgery should be stressed:
1.The surgery is safe and effective.
2.The eyeball is never removed from the orbit to perform the surgery.
3.More than one operation may be required to establish alignment.
4.Both eyes may require surgery to correct the strabismus.
Pediatric cataracts are an important cause of amblyopia in children and require prompt intervention at the earliest possible time.
If congenital glaucoma is recognized early and appropriate treatment is instituted, prognosis is excellent. There is a poor prognosis if glaucoma presents within the first month or after 2 years of age. Treatment is primarily surgical; however, medical therapy is indicated immediately following the diagnosis in the preoperative period if surgery is to be delayed. It is also indicated in patients who do not respond well to the surgical treatment. Patients with congenital glaucoma require long-life follow-up. An IOP rise can occur anytime and must be detected early and treated appropriately.