National Eye Health Week 2017

“Amblyopia is a condition where the observer sees nothing and the patient sees very little.” (Von Graefe 1888).

Poor vision in young children is generally due to the presence of amblyopia (lazy eye). It is a developmental disorder in which there is reduced vision, despite wearing glasses. Typically it affects one eye but it can affect both. Visual development in humans occurs within the first 7- 8 years of life, therefore in order to restore good vision early treatment is indicated. As there are few signs and symptoms to observe detection is very difficult for parents/carers.

The United Kingdom National Screening Committee recommends children’s vision screening takes place between the ages of 4-5 years. In Bradford all children are offered vision screening in their first year (Reception) at school, this is carried out by orthoptists (professionals trained in testing vision in young children). If a child misses the assessment in their school parents are advised to take their child to a local optometrist (optician) for an eye examination.

Early literacy is a key indicator of educational attainment in later life, it is therefore important to investigate factors that influence early literacy. In our current study in Bradford funded by the NIHR (www.nihr.ac.uk) we are examining the levels of children’s vision as they progress through the first three years of school and how this will impact on their developing literacy. Initial findings suggest that poor vision is associated with reduced developing literacy.

“Kids who fall behind in reading fall behind in life” (David Friedman, Director, Center for Preventive Ophthalmology, Baltimore).

Our research also shows that as with all aspects of life a myriad of things can go wrong and result in children attending school without their glasses. Some children miss the screening assessment; letters sent to the parents go astray, some parents do not realise that sight tests are free for children while others do not know how to go about getting the glasses. Glasses frequently get lost/ broken and parents are unsure of the procedure to replace them. It is also difficult for parents to believe that their child has a vision problem when there are no obvious signs or symptoms. As a result, it is common for children to attend school without their glasses.

In Baltimore they are investigating whether providing children with a second pair of glasses to be kept in school will improve both glasses wear and reading ability. In China a recent study showed children’s glasses wear improved when their teachers were incentivised by being given an i-pad ! Here in Bradford we are currently working with parents and schools to develop an appropriate way to support children in wearing their glasses.

As parents we need to understand the importance of our children wearing glasses. As eye care professionals we need to understand why our patients find difficulty accessing services and complying with treatment, providing appropriate information and encouragement. As teachers we need to recognise the importance of maximising vision to allow children to fully participate in school ensuring opportunity for educational attainment. Vision screening provides the opportunity for universal testing of children’s sight but this needs to be followed up by attendance for eye examinations and adherence to treatment. If we can get the model correct our children will only benefit.

To find out about vision screening in Bradford schools contact:

Janet Barber (Orthoptic Secretary) 01274 364175.

To read about our Born in Bradford research investigating vision and literacy visit: https://borninbradford.nhs.uk/what-we-do/schools/eye-health/

To read the UK National Screening Committee recommendations visit: http://www.screening.nhs.uk/vision-child

Dr Alison Bruce NIHR Post-doctoral Research Fellow/ Head Orthoptist Bradford Teaching Hospitals NHS Trust

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