In his article in the current issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2010; 107[28-29]: 495-9), Wolf A. Lagrèze examines whether or not childhood screening for vision disorders in preschool children is worthwhile.
Eye disorders can occur even in very young children and may threaten their vision. Retinopathy of prematurity is currently the only eye disorder for which ophthalmological screening is provided in Germany. Childhood screening for other eye disorders would also be worthwhile if the disorder to be diagnosed were sufficiently common and successful treatment guaranteed. Amblyopia is defined as a unilateral sight disorder that can weaken the affected eye or the visual apparatus as a whole. Strabismus, for example, hinders visual development and can be treated by temporarily covering the better eye. The most significant study conducted to date tested 6081 seven-year-olds and found that those who had been screened and treated as preschoolers developed visual problems somewhat less frequently than those who had not. The frequency of visual disorders also seems to be correlated to membership of certain social strata. German law establishes vision screening as part of routine childhood examination. However, as not all the doctors who carry out such examination currently receive sufficient training, and as their remuneration is often too low to cover their costs, the program is probably unable to provide what the law establishes.
