Related Experiment Video
Updated: May 10, 2025
Author Spotlight: An Automated Method for Assessing Visual Acuity in Infants and Toddlers Using an Eye-Tracking System
Published on: March 17, 2023
Outcomes of Eye Examination and Vision Screening in Term Infants Presenting to a Tertiary Hospital in Türkiye
Nilüfer Zorlutuna Kaymak1, Ayşin Tuba Kaplan1, Sibel Öskan Yalçın1
1University of Health Sciences Türkiye, Kartal Dr. Lütfi Kırdar City Hospital, Clinic of Ophthalmology, İstanbul, Türkiye.
Insights
Ophthalmic screening in infants identified 13.14% with abnormalities, most commonly congenital nasolacrimal duct obstruction. Improving red reflex testing skills among pediatricians is crucial for early detection of vision-threatening conditions.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Public Health
Background:
- Early detection of pediatric eye conditions is vital to prevent irreversible vision loss.
- Ophthalmic screening programs play a critical role in the medical care of infants.
- Timely intervention in the first few months of life is essential for managing certain eye abnormalities.
Purpose of the Study:
- To evaluate the outcomes of an ophthalmic screening program for infants up to one year of age.
- To identify the prevalence and types of ophthalmic abnormalities in term infants presenting to a tertiary hospital.
- To assess the effectiveness of current screening practices, including the red reflex test.
Main Methods:
- Retrospective review of medical records for 1,035 infants aged ≤1 year.
- Data collection included demographic details, parental concerns, family history, and results of various ophthalmic examinations.
- Analysis of findings such as red reflex, eye movements, strabismus, and specific pathologies.
Main Results:
- Abnormal ophthalmological findings were present in 13.14% of infants.
- Congenital nasolacrimal duct obstruction was the most frequent finding (72.05%).
- Other significant findings included strabismus (8.82%), ptosis (4.41%), and congenital cataract (2.94%).
Conclusions:
- Pediatric ophthalmic screening is essential for identifying potentially vision-impairing conditions.
- There are notable deficiencies in the performance and interpretation of the red reflex test by primary care physicians.
- Enhanced training for family physicians and pediatricians in vision screening, particularly the red reflex test, is recommended.
Objectives:
Ophthalmic screening is an important part of the medical care of children as some eye abnormalities can lead to irreversible vision loss if not treated in the first few months or years of life. The aim of this study is to evaluate the outcomes of the ophthalmic screening program in term infants aged ≤1 year who presented to a tertiary hospital in Türkiye.
Materials And Methods:
The records of 1,035 infants ≤1 year old who underwent ophthalmic screening between November 2019 and February 2022 were reviewed retrospectively. Demographic and medical details, parental complaints about the infants' eyes, family history of ocular, adnexal, and systemic pathologies, light reactions, red reflex test results, eye movements, blink response to light, fixation and following, noticeable strabismus, conjunctivitis, epiphora, anterior segment and fundus pathologies, and treatments applied were recorded. The referring physician (family physician, pediatrician) and reason for reference were also noted.
Results:
Abnormal ophthalmological findings were detected in 136 infants (13.14%). The most common finding was congenital nasolacrimal duct obstruction (72.05%), followed by strabismus (8.82%), ptosis (4,41%), absence of following (3.67%), congenital cataract (2.94%), hemangioma of the adnexa (2.94%), nystagmus (2.94%), albino fundus (1.47%), preretinal hemorrhage (1.47%), and coloboma of the iris and choroid (1.47%). We detected abnormal red reflex in 4 infants who were not referred for red reflex abnormality by the referring physician, while another 4 infants referred for red reflex abnormality had no pathology on ocular examinations including the red reflex test.
Conclusion:
The importance of ophthalmic screening in infants is well appreciated but there are inadequacies in performing and interpreting the red reflex test among family physicians and pediatricians. Efforts should be directed at improving vision screening skills, especially red reflex testing.
