Health Monitoring

Developmental Monitoring

Vision

Hearing

Growth

Suggestions for this site?

Vision

DRAFT:  This information in the Vision section is currently out for review by Pediatric Ophthalmology consultants.

Statements from AAP and Other Organizations Relating to Vision

AAP Policy Statements and Clinical Reports

• Eye Examination in Infants, Children, and Young Adults by Pediatricians (Apr 2003)
• Ophthalmologic Examinations in Children with Juvenile Rheumatoid Arthritis   (May 2006)
• Learning Disabilities, Dyslexia, and Vision (Nov 1998)
• Red Reflex Examination in Infants (May 2002)
• Screening Examination of Premature Infants for Retinopathy of Prematurity (Feb 2006)
• Screening for Retinopathy in the Pediatric Patient With Type 1 Diabetes Mellitus (Jul 2005)
• Use of Photoscreening for Children's Vision Screening (Mar 2002)

Other Statements

• Screening for visual impairment in children younger than five years: Recommendation statement.  US Preventive Services Task Force. (Also summarized in Amer Fam Physician. 71(2):333-336, 2005.)
  www.guideline.gov/summary/summary.aspx?doc_id=4822&mode=full&ss=14
  
• Vision Screening for Infants and Children.  Policy Statement.  American Academy of Ophthalmology. (revised and approved Oct 2001)
  http://www.aao.org/education/statements/loader.cfm?url=/commonspot/
  security/getfile.cfm&PageID=15145
  
• Preschool Vision Screening: Summary of a Task Force Report. Hartmann EE et al.  Pediatrics.  2000 Nov; 106(5):1105-1116.
  http://pediatrics.aappublications.org/cgi/content/extract/106/5/1105
  
• Pediatric eye and vision examination: Reference guide for clinicians. (Optometric Clinical Practice Guideline - American Optometric Association Consensus Panel on Pediatric Eye and Vision Examination)  Scheiman MM, Amos CS et al.  American Optometric Association.  St. Louis, MO. 2002.
  http://www.aoa.org/documents/CPG-2.pdf

Guidelines for Referral to a Pediatric Opthalmologist (AAP) - Surgical Advisory Panel (July 2002)

A pediatric ophthalmologist has completed a residency in ophthalmology, is certified by the American Board of Ophthalmological Surgery, and has completed additional training in pediatric ophthalmology. For purposes of developing these guidelines, the following age group definitions are used: infant (0–1 year), child (2–12 years), and adolescent (13–18 years).

Pediatric patients with the following conditions should be referred to a pediatric ophthalmologist:

• Children 7 years or younger who are nonverbal or unable to read letters and in whom there is reason to suspect eye disease.
  
• Infants or children with retinoblastoma or other tumors of the eye and orbital area.
  
• Infants or children with known or suspected cataracts, glaucoma, or blindness.
  
• Infants or children diagnosed with, or at risk of, retinopathy of prematurity.
  
• Infants or children with congenital or genetic ocular anomalies or infections (eg, aniridia, toxoplasmosis).
  
• Infants or children with systemic syndromes, metabolic disorders, or chromosomal abnormalities with possible ocular involvement (eg, juvenile rheumatoid arthritis, galactosemia, diabetes mellitus, Marfan syndrome, Down syndrome).
  
• Infants or children suspected of being abused and in whom there is a possibility of eye injury.
  

Pediatric patients with the following conditions are preferably managed by a pediatric ophthalmologist:

• Infants with congenital nystagmus and children with early onset nystagmus.
  
• Children with strabismus or amblyopia (ie, dimness of vision without detectable organic lesion of the eye) or risk factors for strabismus or amblyopia (eg, family history of amblyopia, orbital or eyelid hemangioma).
  
• Children with a family history of congenital or genetic ocular anomalies (eg, aniridia), infections (eg, toxoplasmosis), tumors (eg, retinoblastoma), or a family history of systemic or metabolic syndromes (eg, juvenile rheumatoid arthritis, galactosemia, diabetes mellitus), chromosomal abnormalities (eg, Down syndrome), or other disorders with possible ocular involvement.
  
• Infants or children with exposure during gestation to drugs or other substances (including alcohol) that may cause congenital anomalies of the eyes.
  
• Infants or children with poor vision or delayed attainment of vision-related developmental milestones and infants and children with severe refractive errors or a strong family history of severe refractive errors.
  
• Infants or children with ocular or periocular inflammation not responding to initial topical and/or systemic antibiotic therapy or not clearing within 3 weeks of treatment and children with suspected herpes simplex or zoster infections involving the eye or a history of these infections involving the eye.