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August is Amblyopia Awareness Month, a reminder of the urgent need for annual photoscreening to detect amblyopia risk factors in children too young for a visual acuity test.

Amblyopia is the number one cause of childhood vision loss. But when it is caught early enough, corrective treatment is effective.

A child may still need to wear glasses, but it is possible to prevent vision loss associated with amblyopia if timely vision screenings are performed, such as during annual child well-check exams.

What Is Amblyopia?

Amblyopia (\ˌam-blē-ˈō-pē-ə\) is a condition that can develop when one eye has poor vision. The brain favors the “good” eye and ignores the images coming from the eye with poor vision.

This prevents the vision from fully developing and can cause permanent vision loss in the affected eye.

When this happens, even glasses cannot help make up for the vision that has been lost. Glasses can still be prescribed to help a child see more clearly, but perfectly clear vision cannot be obtained when amblyopia has caused some vision loss.

Amblyopia Facts:

  • Approximately 15%–20% of children are at risk for amblyopia1
  • Amblyopia treatment works best before the age of 5.
  • Only a fraction of children receive conclusive and timely screenings that could detect their amblyopia risk.2
  • The American Academy of Pediatrics recommends photoscreening to detect amblyopia risk factors for children aged 12 months to 5 years.3

What Are The Risk Factors for Amblyopia?

There are several conditions that can lead to amblyopia, including:

  • Nearsightedness (myopia)
    The ability to see up close but not far away
  • Farsightedness (hyperopia)
    The ability to see far away but not up close
  • Unequal prescriptions between both eyes (anisometropia)
    The condition that results when the vision in each eye is different

When any of these risk factors are detected, it is possible that a child could have or develop amblyopia. And whether or not amblyopia is present, the risk factors alone may require a prescription for glasses so the child is able to see clearly.

GoCheck Kids helps pediatricians detect these risk factors with high specificity in patients as young as 6 months old.

What Can Be Done About Amblyopia?

You can be part of the solution to help prevent permanent childhood vision loss caused by amblyopia. This way, you ensure that all your patients are able to see their full potential later in life.

GoCheck Kids is used by 6,500 pediatricians to help detect amblyopia risk factors (myopia, hyperopia, anisometropia) before the child is old enough for a visual acuity test.

During the earliest years of life, detection of amblyopia risk and treatment for amblyopia is critical in order to prevent permanent vision loss.

Take Action Today!

Amblyopia Awareness Month is a perfect reminder of the critical need for early childhood vision screening to help end amblyopia.

Join 6,500 of your peers who have made the decision to prevent permanent vision loss with GoCheck Kids.

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Vision loss is a silent disease. Often in children, the loss is asymmetrical; one eye sees a lot better than the other one. This childhood loss accounts for 2%-5% of the adult population. It is estimated that about 20% of all school-age kids have difficulty seeing[1].

Vision loss can be reversed until about 7-9 years of age. In 1981 David Hubel and Torsten Weisel won the Nobel Prize for their research that decoded how vision works.

In babies, vision loss is most often structural: corneal opacities, cataracts, retinoblastomas. The red reflex is not clear, and often different than the other eye.

For those older than one year it is frequently from strabismus (eyes turning in ((esotropia) or out (exotropia)).  The invisible and most common issue is the visual loss, which can occur in different types of refractive (optical) basis. In these kids, the red reflex is normal, and structurally the eye is normal. However, the optics of the eye are out of bounds. This can be because the optics are not the same (one eye myopic/the other not, one eye hyperopic/the other not), or the eyes are very myopic (nearsighted) or hyperopic (farsighted). Both myopic and hyperopic kids have trouble seeing at a distance.

Because the targets young kids see are not very tiny, they seem to be functioning normally. Older school-age kids often go close to an object, and parents and the kids are unaware that they cannot see.

How can we find these kids?

The standard of care from the American Academy of Ophthalmology[2], the American Academy of Pediatrics[3], and the American Association of Pediatric Ophthalmology and Strabismus[4] is PHOTOSCREENING. This uses a device to shine a light into the eye and decode the optics of the eye. It will tell you if it is in bounds or out of bounds, and if a detailed Ophthalmological exam is needed.

Older kids can read the Snellen Chart. The Snellen number chart has nine digits, which works well for kids who do not read the English alphabet.

When a child is diagnosed with decreased vision, it is a medical emergency to decode the time frame of care. Cataracts and tumors are treated immediately.

For the amblyopic kids, their brains are quite “moldable.” The younger they are, the much faster it goes in reversing the visual loss. As they approach seven years of age, the changes most often are slow. School-age kids have increasing visual demands. Treatment for a visually impaired child has them function with the less well seeing eye, and it is quite challenging for both the kids and parents. The earlier they begin, the faster it goes. Maintenance of the vision until nine is mandatory and a bit of a long haul.

Vision is a silent disease and has significant consequences for children on many levels. The earlier they are diagnosed, the better the outcome and the easier it is to treat them. Vision loss is a national health issue. Find the Kids, Please.

More About The Author:

Dr. Pamela Gallin is one of the highest-ranking female surgeons at New York Presbyterian-Columbia Medical Center, where she is a Clinical Professor of Ophthalmology in Pediatrics at the Morgan Stanley Children’s Hospital and The Edward S. Harkness Eye Institute of Columbia University Medical Center. She is Director Emeritus of Pediatric Ophthalmology and Adult Strabismus.

 

[1] https://www.cdc.gov/visionhealth/basics/ced/fastfacts.htm

[2] https://eyewiki.aao.org/Photoscreening

[3] https://pediatrics.aappublications.org/content/109/3/524

[4] https://aapos.org/glossary/photoscreening

 

Image by Nguyen Dinh Lich from Pixabay.

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