Preschool vision screening: update on guidelines and techniques.

PURPOSE OF REVIEW: To discuss the current preschool vision screening (PVS) guidelines and review some of the newest vision screening techniques. The different vision screening practices and barriers to screening are discussed. RECENT FINDINGS: Vision screening guidelines, which have been developed in response to the advances in technology and increased understanding of the developing visual system, have been recently updated by some of the major medical organizations that endorse vision screening. With advances in vision screening technology, there is a growing trend for screening at younger ages. SUMMARY: PVS has been widely endorsed by various medical organizations as an effective way to detect preventable and treatable vision problems of childhood. Although PVS is widely recommended, actual screening rates remain low. There are several real and perceived barriers to screening which often prevents successful screening programs. Current vision screening guidelines take into account the recent advances in technology. With the development of new devices, vision screening can effectively be performed at younger ages.

Pediatric ophthalmology in the developing world.

PURPOSE OF REVIEW: It is estimated that of the 45 million people who are blind worldwide in 2000, 1.4 million are children from middle-income and low-income countries, the majority of whom live in the poorest regions of Africa and Asia. The focus of this paper is to discuss the status of pediatric ophthalmology in developing countries and the progress that has been made in the areas of avoidable childhood blindness and visual impairment, particularly corneal scarring as a result of vitamin A deficiency, congenital cataract and retinopathy of prematurity. In addition, we will review the prevalence of uncorrected refractive error and discuss the access to pediatric ophthalmologists in developing countries. RECENT FINDINGS: Some developing countries have begun incorporating vitamin A supplementation and measles immunizations and have seen a decrease in xerophthtalmia. With improvement in vitamin A status, cataract is becoming a more apparent cause of treatable childhood blindness. Amblyopia and uncorrected refractive errors are important and inexpensively treatable causes of visual impairment, with myopia being most common. As neonatal intensive care services in middle-income developing countries improve the survival of premature infants, retinopathy of prematurity is emerging as a significant cause of childhood blindness. SUMMARY: Childhood blindness and visual impairment in developing countries remains a significant public health issue, but recent initiatives have shown promise of future improvements.