The Incidence of Reduced Visual Acuity and Squint in Pre- School Children Aged Three in Australia.

Anne Fitzgerald, DipApSciOrth (Cumb), MPH (Syd)

Three thousand and twenty 3 year old children attending pre-schools throughout Australia were screened by orthoptists.  Testing included visual acuity (VA) , using Sheridan Gardiner single letters at 6 metres and cover test. The incidence of reduced VA (6/9 or worse testing with SG singles) when testing in a classroom situation was 14.7%. A difference of more than one line in VA between the two eyes occurred in 14.9% of the children. (6.5% of the children could not do the SG singles VA test at 6 metres).  The incidence of strabismus was 2.4%.

Children who were found to have reduced VA together with those with strabismus maybe considered to be ‘at risk’ of having or developing amblyopia. Such risk can only be ruled out by having the child referred for a full ocular examination in a clinical setting. Without regulated pre-school assessment many ‘at risk’ three year old children may not be identified until such time as the child is routinely screened at school. By then valuable time for the treatment has been lost.