The next time you visit our office with a child between the ages of one and three you might see a new piece of equipment being used to screen your child’s vision---the PlusoptiX mobile vision screener. What are we looking for when using this new piece of equipment? We are trying to detect one of several causes of AMBLYOPIA.
Before we talk about amblyopia and why it is so important, let’s take a brief detour to discuss the concept of screening your child for diseases. Screening plays a big role in pediatrics and is especially important to help us detect conditions that have very few symptoms, and if not diagnosed in a timely fashion, can produce serious medical problems. A good screening test has two important features. First, it should detect all those who actually have a medical problem and very few patients who are actually normal. Secondly, there should be effective medical treatment that when started right away will prevent the problem from becoming more significant. Your child is screened in the hospital for 35 metabolic diseases (in Missouri) prior to coming home by several drops of blood on a piece of filter paper. We screen your child’s growth, development, hearing, straightness of the back (scoliosis), cholesterol (now routinely at age 8), and many other conditions.
So what is AMBLYOPIA? This is when poor vision develops because of abnormal development in the visual pathways of the brain. The most common cause is strabismus (lazy eye) where the brain only pays attention to the good eye and vision is eventually lost. Other causes are anisometropia (unequal refractive errors) and anything that can obstruct vision like cataracts, droopy eyelids, etc. Unfortunately, these problems can be easily missed as they do not necessarily cause symptoms and the young child will rarely complain of decreased vision. If detected, treatment can prevent amblyopia from getting worse by patching the eyes or wearing glasses or removing a cataract for example.
We have always screened your child for amblyopia by performing a cover-uncover test carefully watching the uncovered eye for unusual movement while focusing on an object. We also use our ophthalmoscope to check for cataracts. These tests can be difficult to perform in the children most at risk (those less than 3 years old) as they are less cooperative. Detecting differences in vision between the two eye is especially difficult.
So, it is 2014 and we have new technologies (photoscreening) and new recommendations from the American Academy of Pediatrics endorsing the use of automated vision testing. At Esse Health, each of our offices will be using an instrument routinely at your checkups for children 1-3 years of age. Those children who fail this screen will likely be referred to a pediatric ophthalmologist for further evaluation and treatment. Most, but not all insurers, will pay for this type of screening.
We consider it a privilege to be trusted to care for your children. Preventing amblyopia is just one of the many things we are watching for and we believe this new technology will assist us in finding all our patients at risk for developing this condition.
By Dr. Richard Lazaroff Creve Coeur Pediatrics
11630 Studt Avenue, Suite 200
Creve Coeur, MO 63141
Phone: 314.567.7337
