Refractive errors cause decreased vision, visual discomfort ("eye strain"), and/or amblyopia. The most common form, nearsightedness (poor distance vision) is usually seen in school-age children and is treated effectively, in most cases, with glasses. Farsightedness can cause problems with focusing at near and may be treated with glasses. Astigmatism (imperfect curvature of the front surfaces of the eye) also requires corrective lenses if it produces blurred vision or discomfort. Uncorrected refractive errors can cause amblyopia particularly if they are severe or are different between the two eyes.
In addition to detection of vision problems, effective screening programs should also place emphasis on a mechanism to inform parents of screening failures and attempt to ensure that proper follow-up care is received.
Amblyopia is poor vision in an otherwise normal appearing eye, which occurs when the brain does not recognize the sight from that eye. Two common causes are strabismus (misaligned eyes) and a difference in the refractive error (need for glasses) between the two eyes. If untreated, amblyopia can cause irreversible visual loss. The best time for treatment is in the preschool years. Improvement of vision after the child is 8 or 9 years of age is rare.
Strabismus is misalignment of the eyes in any direction. Amblyopia may develop when the eyes do not align. If early detection of amblyopia secondary to strabismus is followed by effective treatment, then excellent vision may be restored. The eyes can be aligned in some cases with glasses and in others with surgery. However, restoration of good alignment does not assure elimination of amblyopia, and continued care after restoration of good alignment is essential.
The physicians at EyeHealth Northwest recommend an ophthalmological examination be performed whenever questions arise about the health of the visual system of a child of any age. They recommend that infants and children be screened for vision problems as follows and any child who does not pass these screening tests have an ophthalmological examination.
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