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The Importance of Early Childhood Eye Screening

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Jill Baer noticed her young son, Ethan, sometimes squinted while riding in the car, but she figured that was just normal behavior for an active 4-year-old. However, during his annual wellness check-up with a Northwestern Medicine Regional Medical Group pediatrician, an electronic eye screening revealed that Ethan may be suffering from vision impairment. A visit to the ophthalmologist confirmed amblyopia, the leading cause of vision loss among children.

The eye screening tool, which is now in use at all five Northwestern Medicine Regional Medical Group pediatric sites of care, uses smartphone technology to take a photograph of the patient’s eyes. Computer software reads light reflection from the eyes and analyzes the image to determine if the child might need eye correction. The screening is being offered to patients from 12 months to five years of age during annual wellness visits.

“Without the technology, pediatricians must rely on visual inspection to see how the eye is moving. It can be very difficult to detect subtle abnormalities,” said Karen Judy, MD, the Northwestern Medicine Regional Medical Group pediatrician who spearheaded the screening program. “As you can imagine, it is tough to reliably test vision in a young child with limited communication skills.”

Amblyopia, commonly known as lazy eye, occurs when one eye does not fully develop during early childhood. The brain favors the better eye and the weaker eye gets progressively worse. Because the stronger eye compensates for the shortfall and the eye itself looks normal, amblyopia often goes undetected until children have their first official visit to the eye doctor, usually during kindergarten.

Ethan’s follow-up testing determined his left eye was significantly weaker than the right. He was fitted with glasses and underwent daily eye-patching, in which his better eye was covered with a patch for up to four hours a day to improve vision in the weaker eye.

“The ophthalmologist was grateful we came in when we did. If we had waited another two years, the amblyopia would have been challenging to improve due to the muscles getting weaker,” said Baer. “There was a chance the muscle would just quit, and we could have missed the window to improve Ethan’s eyesight.”

“Ethan’s jaw dropped the first time he put on his glasses. I think everything must have been a blur before,” said Baer. “It was remarkable to witness him seeing things clearly for the first time. He commented that he could finally see what was inside the jelly bean jar instead of just the jar.”

According to Dr. Judy, the eye screening has identified an average of one patient each month with a vision concern that previously wouldn’t have been detected with a normal medical exam.

“Amblyopia can result in permanent vision loss if not diagnosed early,” said Dr. Judy. “By intervening sooner, we are seeing much better outcomes.”

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