Identifying visual difficulty in children with special educational needs: Where should we look?

摘要

In the UK, universal child screening for eye defects or reduced vision is recommended at birth, 6-8 weeks and 4 years. A physical examination of the baby's eyes is carried out to detect significant structural abnormalities or media opacities manifesting with an abnormal red reflex. Early diagnosis facilitates prompt treatment to preserve or restore vision, and/or the introduction of early support to improve visual and developmental outcomes if severe visual impairment is inevitable. In addition, babies born prematurely are screened for retinopathy of prematurity. At 4 years of age, screening should be orthoptist led; via measurement of monocular acuity, the principal aim is to detect children with significant amblyopia who will benefit from treatment to improve vision in the 'blunted' eye. Although auditing of the programme is not well established, its contribution to the detection of severe visual impairment has been demonstrated by Rahi et at who reported on the outcome of a 1-year period of active case finding of children newly diagnosed with severe visual impairment (defined as acuity worse than logMAR 1.0)1 (Snellen 6/60).