Early visual screening appears essential to detect complete amblyopia risk and to treat strabismus earlier
(Intérêt du dépistage visuel pour détecter les risques de d'amblyopie et traiter les strabismes)

Bois C, Binot MC, Jonqua F, Mouret MF, Guillemot G, Bremond-Gignac D.
Service Départemental de PMI, Conseil Général des Hauts de Seine, Nanterre, France.

INTRODUCTION: Early medical examinations performed in 2-, 4-, 9-, and 24-month-olds need to set up a technique adapted to infants and children. The aim of this study was to describe the technique and the results of screening performed by physicians of the Hauts-de-Seine district in 2004.

PATIENTS AND METHODS: Over 1 year, 17 participating centers of the Maternal and Infant Welfare department of the Hauts-de-Seine district (France) included 1366 children at the  9- and 24-month medical consultation. This standardized procedure looked for personal and family risk factors and sought to detect ocular anomalies, strabismus, and amblyopia. Depending on the results, the patient was oriented toward appropriate care.

RESULTS: At inclusion, only 10% of the children had already consulted an ophthalmologist with insufficient numbers in the risk groups although the difference between groups was significant. Of the children included, 30.2% had a family history of visual impairment and 7% a personal risk. During the examination, a risk of visual impairment was suspected for 12.5% of the children. At the end of the consultation, 39.7% of the children were oriented to an ophthalmic consultation, with the history or the results of the examination. One of these children out of two underwent a consultation. Finally, 31 children were prescribed corrective glasses compared to only eight wearing glasses initially and 65 children were followed up as opposed to only seven children before the study.

CONCLUSION: This screening has led to quadrupling the number of children wearing corrective lenses and monitoring the others presenting visual abnormalities, confirming the advantages of early visual screening for children under 3 years of age.

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