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Ophthalmic screening of 38,000 children, age 1 to 2 1/2 years, in child welfare clinics
Insights
Strabismus affects 1.3% of young children, with esotropia being most common. Rapid retinoscopy is recommended for early detection of vision problems in children.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Vision Science
Background:
- Strabismus and amblyopia are significant pediatric vision concerns.
- Early detection and intervention are crucial for optimal visual development.
Purpose of the Study:
- To determine the prevalence of strabismus and strabismic amblyopia in a large infant cohort.
- To identify associated refractive errors and ocular conditions.
- To evaluate the efficacy of rapid retinoscopy in screening.
Main Methods:
- Screening of 38,000 infants aged 1 to 2.5 years.
- Prevalence assessment of strabismus and amblyopia.
- Analysis of refractive errors (ametropia, hypermetropia, myopia, anisometropia) and strabismus types (esotropia, exotropia).
- Evaluation of rapid retinoscopy for detecting refractive errors and media opacities.
Main Results:
- Prevalence: 1.3% strabismus, 0.5% strabismic amblyopia.
- Esotropia was more common than exotropia; half of esotropia cases were amblyopic.
- Significant ametropia (>50%), myopia, and anisometropia were frequent findings.
- Rapid retinoscopy proved efficient for detecting refractive errors and potential amblyopia.
Conclusions:
- Strabismus and amblyopia are prevalent in early childhood.
- Refractive errors frequently coexist with strabismus.
- Rapid retinoscopy is a valuable, efficient tool for pediatric vision screening.
Abstract:
Screening of 38,000 infants, age 1 to 2 1/2 years, showed a prevalence of 1.3% of strabismus and 0.5% of strabismic amblyopia. Esotropia was more than three times as frequent as exotropia. Approximately half of the cases with esotropia were amblyopic. Eighty-one percent of the cases with exotropia were intermittent, and in 29% the V-pattern was found. Significant ametropia was found in over 50% of the cases with strabismus. Although hypermetropia was the most frequent refraction in children with esotropia, myopia was a frequent finding in both esotropia and exotropia. Anisometroia was particularly frequent in constant unilateral esotropia. Accommodative strabismus was found in 7% of cases with infantile esotropia. In cases with paralytic strabismus, the most frequent muscle involved was the lateral rectus. Significant organic pathology, other than strabismus or amblyopia, was revealed in 0.2% of the series. "Rapid retinoscopy" through undilated pupils is an efficient method in detecting high refractive errors and candidates for nonstrabismic amblyopia in childhood. Since this method of examination is easy to perform, its adoption as a part of screening projects in childhood is recommended. "Rapid retinoscopy" performed by a trained orthoptist is also a useful method for detecting opacities in the ocular media.