Vision Screening Online Training Program

Module 2: Vision History
(C&TC: Often performed by the health care provider)

Taking a thorough vision history is very important. Research shows that several eye problems can be detected by taking a vision history alone. For instance, up to 40% of children with crossed eyes (strabismus) have a family history of strabismus. Additionally, more than 60% of cases of blindness among infants are caused by inherited eye diseases such as congenital (present at birth) cataracts, congenital glaucoma, and retinal degeneration. In addition, nearsightedness, farsightedness, lazy eye (amblyopia) and astigmatism are often hereditary.

It is also important to ask the parent about their child’s history of certain diseases because certain diseases may lead to or be associated with eye problems. For example, 45% of children with hearing loss may also present with eye abnormalities. If an infant has jaundice and low blood sugar in the hospital nursery, the infant is at higher risk for optic nerve hypoplasia.

CHILD AND FAMILY VISION HISTORY PROCEDURE (Often conducted by the health care provider as part of health history)

Ages: Perform at birth to 5 years or at any age if family history is unknown. Continue to update ocular history at each subsequent well child visit.
Purpose: To identify a family history of medical conditions with high frequency of associated eye disorders. Referral due to positive family history, prenatal, and perinatal issues have been shown to lead to earlier diagnoses of amblyopia or amblyogenic factors.
Description: Asking parents or guardians if their child has any of the selected medical conditions and syndromes on the vision behavior developmental checklist or the vision history questions list. A “yes” response may indicate the need for referral even if other screening procedures are passed.
Equipment:

“Vision Behavior” checklist

Vision History and Questions list

A quiet, private area to allow for confidentiality

Procedure:

A health professional asks a parent about the child’s vision history. Explore whether any near relative (i.e. parent, grandparent, sibling, aunt or uncle) had or has any of the following conditions, ask questions relating to the family history, and ask about complaints and behaviors of the child (See below).

Vision screener going over directions, instructions with parent and child.

Pass: No family history of associated conditions or syndromes.
Refer: Family history of associated conditions or syndromes.
Comment: If the parent or guardian has any concerns regarding the child’s vision or history, it is recommended that the child be referred to an eye professional for further evaluation. If the child is developmentally able, ask the child questions such as if they get a headache with reading or if they have to squint to see items. Children often do not complain or seek help as if they have always seen things in a blurred or distorted way; they accept the imperfect image without question. This interview may be the first time they have been asked these questions and the parent may not be aware that there was or is a problem.

Question

Children with a family history of eye conditions only have a small likelihood of developing an eye condition themselves?
True
False


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