Romano P E
Pediatrician. 1990;17(3):134-41.
Eye and vision screening is a prototype preventative health measure. Increased knowledge of eye diseases in children and their treatment mandates much earlier screening than was recommended in the past. Advances in testing permit both the adoption of simpler and faster routine techniques and the application of more sophisticated and accurate screening methods. A thorough vision/eye screening at 6 months of age has been added to the previous examination schedule which only required screening at birth and again at 3.5-4 years of age. The simple scrutiny of the red fundus reflexes in the pupil with a direct ophthalmoscope (Brückner test) provides superior screening for vision, binocular alignment and pathology in infants. The difficult-to-master cover test and its variants can be abandoned for screening purposes. In screening preverbal children, simple optotype charts (HOTV) are proving more efficient than the traditional 'tumbling E' game. Color vision testing should be added to the preschool examination. Vision screening in infants can be enhanced where resources permit by using new preferential looking tests and by employing sophisticated electrophysiological testing. Photographic screening methods based on the red reflex hold considerable promise for more efficient screening of children.
眼部和视力筛查是一种预防性健康措施的范例。对儿童眼部疾病及其治疗的了解不断增加，这就要求比过去建议的时间更早地进行筛查。检测技术的进步使得既可以采用更简单、快速的常规技术，也可以应用更复杂、准确的筛查方法。之前的检查时间表仅要求在出生时和3.5至4岁时进行筛查，现在在6个月大时增加了一次全面的视力/眼部筛查。用直接检眼镜对瞳孔中的红色眼底反射进行简单检查（布吕克纳试验），能为婴儿的视力、双眼视轴矫正和病变提供更好的筛查。为了筛查目的，可以放弃难以掌握的遮盖试验及其变体。在筛查不会说话的儿童时，简单的视标图表（HOTV）比传统的“翻转E”游戏更有效。学龄前检查应增加色盲测试。在资源允许的情况下，通过使用新的优先注视测试和采用复杂的电生理测试，可以加强对婴儿的视力筛查。基于红色反射的摄影筛查方法有望更有效地筛查儿童。
