Practice Policy Update Regarding COVID-19

Written By: Reena Mukamal

Vision screenings for young children usually take place during wellness visits to the pediatrician. But with wellness visits declining during the coronavirus pandemic (COVID-19), many children’s eyes may go unchecked.This could delay the diagnosis and treatment of childhood eye conditions — particularly for children from disadvantaged households, who were already prone to missing vision screens before the pandemic.“A well-child visit to the pediatrician accomplishes the vision screening and so much more, from assessing physical, developmental and social-emotional health to providing protection through immunization. It’s imperative that parents don’t skip these appointments, even during the COVID-19 pandemic,” says ophthalmologist Aaron M. Miller, MD.

Could the coronavirus pandemic worsen disparities in vision care?Before COVID-19, only 6 out of 10 preschool-aged children had their vision screened by a health professional, according to a study by the Centers for Disease Control and Prevention. Some children were far less likely to get a vision screen. Only 57% of children whose parents lacked higher education, 59% of children living far below the federal poverty level and 59% of Hispanic children had received their vision checkup.By contrast, nearly 70% of children with college-educated parents, 67% of children living well above the poverty level, 65% of white children and 63% of African American children had been screened.It’s not yet clear how children from disadvantaged households have fared during COVID-19. But the pre-COVID-19 gap is troubling because certain groups, including Hispanic children, face a higher risk of serious eye disease. One of the largest studies of childhood eye conditions in ethnic groups, the Multi-Ethnic Pediatric Eye Disease Study, found that African American and Hispanic children are more likely than white children to develop:

Amblyopia, also called lazy eye, a condition that weakens vision in one eye and can cause permanent vision loss if left untreated;

Astigmatism, an unevenly curved cornea or lens that blurs or distorts vision

Why children shouldn’t skip preschool vision screenings during COVID-19
Vision screenings are crucial in preschool years because young children may not be able to describe vision problems to their parents. Small kids may not even be aware that they’re not seeing as well as they should.Screenings can help catch problems early, while vision is still developing. Misalignment, refractive errors, and other problems that block healthy vision in a developing eye may still be improved or corrected during in the first five to seven years of a child’s life. But if early signs are missed or overlooked, there’s no going back.The Academy recommends that all children have their eyes checked at regular intervals, even if they have no symptoms. Kids should be referred to an ophthalmologist if they show signs of:

misaligned eyes (strabismus)

“lazy eye” (amblyopia)

refractive errors (myopia, hyperopia, astigmatism) or another focusing problem.

If the pediatrician finds that the child might have amblyopia or another eye problem, they will send the child to an ophthalmologist for further testing.

Shared from the AAO

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