Childhood Eye Examination in Primary Care. 2023

Alexis Reedy-Cooper, and Christina Scartozzi, and Theresa Yurkonis
Pennsylvania State University College of Medicine, Reading, Pennsylvania.

Approximately 7% of children in the United States younger than 18 years have a diagnosed eye disorder, and 1 in 4 children between two and 17 years of age wears glasses. Routine eye examinations during childhood can identify abnormalities necessitating referral to ophthalmology, which optimizes children's vision through the early diagnosis and treatment of abnormalities. The U.S. Preventive Services Task Force recommends vision screening at least once in children three to five years of age to detect amblyopia or its risk factors to improve visual acuity. The American Academy of Family Physicians supports this recommendation. The American Academy of Pediatrics recommends screening starting at three years of age and at regular intervals in childhood, and that instrument-based screening (e.g., photoscreening, autorefraction) is an alternative to vision charts for testing visual acuity in patients three to five years of age. Eye examinations include visual acuity testing, external examinations, assessing ocular alignment and pupillary response, and assessing for opacities with the red reflex examination. Common abnormalities include refractive errors, amblyopia (reduction in visual acuity in one eye not attributable to structural abnormality), and strabismus (misalignment of the eye). Rare diagnoses include retinoblastoma (often detectable through loss of red reflex), cataracts (detectable by an abnormal red reflex), and glaucoma (often manifests as light sensitivity with corneal cloudiness and enlargement).

UI MeSH Term Description Entries
D011320 Primary Health Care Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192) Primary Care,Primary Healthcare,Care, Primary,Care, Primary Health,Health Care, Primary,Healthcare, Primary
D012030 Refractive Errors Deviations from the average or standard indices of refraction of the eye through its dioptric or refractive apparatus. Ametropia,Refractive Disorders,Ametropias,Disorder, Refractive,Disorders, Refractive,Error, Refractive,Errors, Refractive,Refractive Disorder,Refractive Error
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000550 Amblyopia A nonspecific term referring to impaired vision. Major subcategories include stimulus deprivation-induced amblyopia and toxic amblyopia. Stimulus deprivation-induced amblyopia is a developmental disorder of the visual cortex. A discrepancy between visual information received by the visual cortex from each eye results in abnormal cortical development. STRABISMUS and REFRACTIVE ERRORS may cause this condition. Toxic amblyopia is a disorder of the OPTIC NERVE which is associated with ALCOHOLISM, tobacco SMOKING, and other toxins and as an adverse effect of the use of some medications. Anisometropic Amblyopia,Lazy Eye,Amblyopia, Developmental,Amblyopia, Stimulus Deprivation-Induced,Amblyopia, Suppression,Stimulus Deprivation-Induced Amblyopia,Amblyopia, Anisometropic,Amblyopia, Stimulus Deprivation Induced,Amblyopias,Amblyopias, Anisometropic,Amblyopias, Developmental,Amblyopias, Stimulus Deprivation-Induced,Amblyopias, Suppression,Anisometropic Amblyopias,Deprivation-Induced Amblyopia, Stimulus,Deprivation-Induced Amblyopias, Stimulus,Developmental Amblyopia,Developmental Amblyopias,Eye, Lazy,Eyes, Lazy,Lazy Eyes,Stimulus Deprivation Induced Amblyopia,Stimulus Deprivation-Induced Amblyopias,Suppression Amblyopia,Suppression Amblyopias
D013285 Strabismus Misalignment of the visual axes of the eyes. In comitant strabismus the degree of ocular misalignment does not vary with the direction of gaze. In noncomitant strabismus the degree of misalignment varies depending on direction of gaze or which eye is fixating on the target. (Miller, Walsh & Hoyt's Clinical Neuro-Ophthalmology, 4th ed, p641) Concomitant Strabismus,Dissociated Horizontal Deviation,Dissociated Vertical Deviation,Heterophoria,Heterotropias,Hypertropia,Non-Concomitant Strabismus,Nonconcomitant Strabismus,Phorias,Squint,Strabismus, Comitant,Strabismus, Noncomitant,Convergent Comitant Strabismus,Mechanical Strabismus,Comitant Strabismus,Comitant Strabismus, Convergent,Deviation, Dissociated Horizontal,Dissociated Horizontal Deviations,Dissociated Vertical Deviations,Heterophorias,Heterotropia,Horizontal Deviation, Dissociated,Hypertropias,Non Concomitant Strabismus,Noncomitant Strabismus,Phoria,Strabismus, Concomitant,Strabismus, Convergent Comitant,Strabismus, Mechanical,Strabismus, Non-Concomitant,Strabismus, Nonconcomitant
D015351 Vision Screening Application of tests and examinations to identify visual defects or vision disorders occurring in specific populations, as in school children, the elderly, etc. It is differentiated from VISION TESTS, which are given to evaluate/measure individual visual performance not related to a specific population. Screening, Vision,Screenings, Vision,Vision Screenings

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