Children often undertake a vision assessment as part of their referral for evaluation of learning difficulties.
However, a study by La Trobe Eye Clinic Coordinator and Master of Applied Science student Kylie Gran found there were great variations in the types of tests conducted on children.
The study analysed 130 responses to an internet-based survey of ophthalmologists, optometrists and orthoptists in Australia, which assessed which tests were conducted and the outcomes.
It found that some disciplines were more likely to assess accommodation - the ability to focus - whilst others were more likely to assess eye coordination or convergence - the ability for the eyes to work together or to move inwards to fix on a nearby object. Additionally, differences were noted in whether eye drops were used to determine a child’s refractive error and need for glasses.
In addition to differences in testing methods, the cost to the family when assessing a child with learning difficulties varied. It was typically more expensive than a standard eye test, the study found.
Ms Gran said despite current guidelines encouraging testing of near visual acuity, focussing and refractive error with drops, these components were not routinely assessed by many participants in this study.
“Children referred for assessment of learning difficulties are recommended a vision test given visual impairment can affect learning. It is vital that visual dysfunction is identified or excluded in these children to ensure targeted and timely intervention,” she said.
“The purpose of this study was to understand what components of vision and binocular vision are routinely assessed by eye health care professionals in Australia when evaluating children with learning difficulties.
“Whilst paediatricians, educational psychologists and other health professionals request a vision test, they are likely unaware of the variation between clinicians as noted in this study.
“It is the intention that this study and further research will initiate discussions about the aspects of vision and binocular function that should be assessed in this patient cohort, ideally with input from representatives across the eyecare sector, to ensure a consistent, thorough and relevant approach.
“Future research should aim to establish minimum standards for assessing this patient cohort to ensure consistent and relevant assessment.”
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DOI: https://www.tandfonline.com/doi/full/10.1080/08164622.2023.2288177
