Strabismus in very low birth weight and/or very preterm children: Discrepancy between age of onset and start of treatment

Present medical care is not sufficient for early detection and treatment of strabismus in at-risk children. Our results suggest that the optimal screening age for early detection of persistent strabismus in VLBW children is at 9 months of age. Because strabismus can also develop after this age, it is important to repeat examination of visual functions in at risk-children at regular intervals after 1 year of age

Screening for suppression in young children: the Polaroid Suppression test

Background: Assessment of monocular visual impairment during screening of young children is often hampered by lack of cooperation. Because strabismus, amblyopia, or anisometropia may lead to monocular suppression during binocular viewing conditions, a test was developed to screen far suppression in young children. Methods: Children were invited to look through two polaroid filters of different polarization direction at two pictures covered with polaroid filters of opposite polarization direction. In this way, each eye could only see one of the two pictures. in cases of suppression, only one picture would be visible. Acuity measurements in 201 B-year-old children were compared with the Polaroid Suppression test (PST) results. Results: The PST had a high success rate (99.5%) and testing time was under 1 minute. Specificity of the PST for acuity impairments was 91%. The low sensitivity of 60% was caused mainly by the fact that some children with binocular acuity impairments were not detected with the PST. However, the PST was highly sensitive for significant interocular acuity differences. Conclusion: The PST has been found to be a useful screening method for amblyogenic factors in young children. The test can be carried out without occlusion of one eye. The apparatus is portable, the test duration is short, and the costs are low. The results indicate that the PST is a very promising tool to use in clinical conditions and for screening large numbers of young children

Screening for suppresion in young children: the Polaroid-Suppression-Test

Background: Assessment of monocular visual impairment during screening of young children is often hampered by lack of cooperation. Because strabismus, amblyopia, or anisometropia may lead to monocular suppression during binocular viewing conditions, a test was developed to screen far suppression in young children. Methods: Children were invited to look through two polaroid filters of different polarization direction at two pictures covered with polaroid filters of opposite polarization direction. In this way, each eye could only see one of the two pictures. in cases of suppression, only one picture would be visible. Acuity measurements in 201 B-year-old children were compared with the Polaroid Suppression test (PST) results. Results: The PST had a high success rate (99.5%) and testing time was under 1 minute. Specificity of the PST for acuity impairments was 91%. The low sensitivity of 60% was caused mainly by the fact that some children with binocular acuity impairments were not detected with the PST. However, the PST was highly sensitive for significant interocular acuity differences. Conclusion: The PST has been found to be a useful screening method for amblyogenic factors in young children. The test can be carried out without occlusion of one eye. The apparatus is portable, the test duration is short, and the costs are low. The results indicate that the PST is a very promising tool to use in clinical conditions and for screening large numbers of young children

Visual outcome at 5 years of newborn infants at risk of cerebral visual impairment

Visual development at 5 sears of age was tested in a group of 39 children who had shown severe neonatal encephalopathy or perinatal brain lesions, documented bs medical history, cranial ultrasound, or MRI. In all children, grating acuity was tested during the first 2 years of life. The assessment protocol at 5 years included various visual functions (grating and resolution acuity, visual field size, depth perception, optokinetic nystagmus, and ocular motility), and neurological and cognitive development. The majority of the children showed visual disorders of different type and degree, which were not due to ophthalmological abnormalities. Visual defects correlated well with the results of early visual assessment and of neuroimaging. Visual outcome could be predicted by grating acuity at 1 to 2 sears in 27 of the 39 children, by neonatal cranial ultrasound in 26 of the 32 cases examined bs this technique, and bs later MRI in 23 out of 27. Moreover, a significant correlation was found between visual, motor, and cognitive impairment