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“我的孩子看不见了”——儿童视力低下的检查与管理:美国小儿眼科与斜视学会低视力康复委员会和遗传性眼病委员会联合研讨会

"My child can't see"-workup and management of children with low vision: a joint workshop of the AAPOS Low Vision Rehabilitation and Genetic Eye Diseases Committees.

作者信息

Ditta Lauren, Utz Virginia Miraldi, Chandna Arvind, Drack Arlene, Reynolds Margaret, Weed Matthew, Dumitrescu Alina, Chang Melinda Y

机构信息

Hamilton Eye Institute, Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee; LeBonheur Children's Hospital Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, Tennessee; Division of Ophthalmology, Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee.

Abrahamson Pediatric Eye Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

出版信息

J AAPOS. 2025 Jun;29(3):104229. doi: 10.1016/j.jaapos.2025.104229. Epub 2025 May 27.

Abstract

Children with visual impairment present a unique challenge to pediatric ophthalmologists. Diagnostic workup may include tests that require specialized interpretation, such as genetic testing and neuropsychological assessments. The differential diagnosis includes rare conditions, such as certain inherited retinal disorders, as well as more common conditions, such as cerebral/cortical visual impairment. Management of children with visual impairment requires ophthalmologists to become familiar with visual prognosis associated with various conditions and supports available for children with low vision, which vary by age. Younger children benefit from early intervention services, which may include pre-braille skills and orientation and mobility training. Older children require counseling with regard to driving, independent skills, and transition to adult care. This workshop provides detailed discussion of differential diagnoses, diagnostic tests, and management strategies in infants and older children with visual impairment. We emphasize the importance of a multidisciplinary approach, since vision impacts development in multiple domains, and many children with visual impairments are multiply disabled.

摘要

视力障碍儿童给小儿眼科医生带来了独特的挑战。诊断检查可能包括需要专业解读的测试,如基因检测和神经心理评估。鉴别诊断包括罕见病症,如某些遗传性视网膜疾病,以及更常见的病症,如脑性/皮质性视力障碍。对视力障碍儿童的管理要求眼科医生熟悉与各种病症相关的视力预后情况,以及为不同年龄段的低视力儿童提供的可用支持。年幼的儿童受益于早期干预服务,这可能包括盲文前技能以及定向和移动训练。年龄较大的儿童需要在驾驶、独立技能以及向成人护理过渡方面接受咨询。本次研讨会详细讨论了视力障碍婴幼儿和大龄儿童的鉴别诊断、诊断测试及管理策略。我们强调多学科方法的重要性,因为视力会影响多个领域的发育,而且许多视力障碍儿童存在多重残疾。

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