Some of the vision problems cited in the literature review included undiagnosed nearsightedness, farsightedness, amblyopia, retinoblastoma, congenital defects, and strabismus.  The report went on to state that a vision screening was not a substitute for an eye exam and that eye exams from an optometrist or ophthalmologist were a very effective way to detect vision problems in children.

In 2004 The Vision council of America estimated that the rate of undetected vision problems in children to be 25%.  The 2010 National Health Objective 28-4 to reduce blindness and visual impairment in children and adolescents has experienced little progress in it’s goal to reduce childhood blindness.

In 2002 the American Public Health Association (APHA) issued a statement supporting regular eye exams in children to improve the detection rate of vision problems instead of regular screenings.  APHA recommended eye exams at age 6 mos, 2 years and 4 years.  A failure of the current screening program is the lack of follow through for children when problems are detected.  “Most forms of vision loss in children are preventable.  Improving the access to eye care for children should be as important as are our current childhood vaccination programs” said Dr. Richard Driscoll.

Sixteen states do not require any vision assessment prior to a child entering school.  The remaining states require some for of vision assessment prior to a child entering school, however only five states require a follow up examination to the screening.  Screenings are clearly not effective if the results are not acted upon.  Only three states, Illinois, Kentucky and Missouri have legislated mandatory eye exams prior to a child entering school.

Cost was found to be an issue with getting visual assessments for children.  Uninsured children did not receive a well child visit 54% of the time.  Often a well child visit includes a visual assessment.

The recommendations of the study to improve access to eye care for children  included funding national campaigns to educate the public regarding the need to seek care for their child, setting up national standards to be adopted by all states, assure adequate vision coverage by all public and private insurers.

For more articles written on The Eye Doc Blog on vision problems in children see

• Survey Shows Most Children Have Never Had an Eye Exam
• Eye Exams are a Crucial Part of Back to School
• When Should My Child Have Her First Eye Exam
• Optometrist and School Nurses Partner to Link Healthy Vision and Classroom Learning
• See our Children tag for all articles written about children on The Eye Doc Blog

Contrast sensitivity function is a measure of visual acuity (the chart on the wall that uses progressively smaller numbers is another, more common method, shown to the right) uses different shades of gray to evaluate a person’s vision rather than how small of a letter a person can read (the latter is called Snellen visual acuity.  Contrast sensitivity is a much more precise way of evaluating a person’s visual acuity and is more often used in clinical research.

The exciting part of this study is that it has been previously thought that it was difficult to improve the vision in adults.   This study paves the way for possible new treatments of amblyopia in children and the hope of retraining patients that may have lost vision due to some retinal conditions.  The study showed that not all games are created equal in producing this affect and advised caution in recommending games to recommend to patients.  The entire study was published online by the journal Nature Neuroscience.