An estimated 1 in 4* of school age children have some sort of visual problem, yet approximately only 1 in 3* children have had an eye test prior to starting school. A recent study* found that 11.5 % of teenagers have undetected or untreated visual problems.
School screening is a worthwhile exercise, but a failure at a screening does not mean the child has a problem, and importantly, passing the screening does not mean the child doesn’t have a problem -Screenings are designed to attempt to maximise sensitivity (catch the problems) and minimise over referrals- failures (Specificity). There is a trade off in screening- the only way to ensure 100% sensitivity would be to fail every child, but that makes it useless. Errors are a fact of screening, and only a full eye examination can determine which children are OK and which are not.
All children should be tested by either their local optometrist or at the local community children’s clinic, even if there is no suspicion of a problem- many childhood visual problems can last a lifetime if not detected early enough. We would recommend a first test aged 3, but at the very latest before starting school in all children who appear to be without problems. Obviously any child with a suspected problem should be seen as soon as possible.
* References are available on request.
More information on children’s eyecare here.