The most significant eye problems during childhood include:
• Amblyopia (lazy eye), which is a reduction in vision arising from a defect present in infancy or early childhood that prevents the eye from receiving adequate visual stimulation.
• Strabismus (squint), which is the incorrect alignment of the two eyes arising from injury or disease affecting the eye muscles, or the nerve supplying the muscles, or a physical obstruction to eye movement. Strabismus is the commonest cause of ambylopia.
• Defective binocular vision, which is the inability to use the two eyes together in the correct way and which leads to impairment of depth perception. This is a consequence of squint and ambylopia.
• Hypermetropia (longsightedness).
• Myopia (shortsightedness) in older children.
There is little doubt of the importance of eye testing for children. Young children are unable to self refer and if problems are not caught at an early stage they can lead to serious sight problems if left undetected and untreated. For example a squint or astigmatism may lead to permanent visual loss. A child’s eyesight goes through a crucial period of development from birth to age 7. The earlier amblyopia treatment is instigated the greater the improvement in terms of acuity. The UK National Screening Committee says that “there is evidence that early intervention has a beneficial effect” and that “ideally strabismic amblyopia should be treated before the age of 3 years but some improvement can be obtained later than this”.
Undetected and untreated eye problems in early childhood can have far reaching consequences. From a young age and in particular once entering school children go through a vital learning period. Poor eye sight or eye problems can slowdown a child’s progress in school intellectually and socially. Inability to read, see the black/white board, engage with other pupils and play sport can have a disastrous effect on a child. It is not unknown for young children to be placed in special needs classes simply because of undetected eye problems.