[Detection of visual anomalies in children of 10 months, 2 and 4 years of age. Child health evaluation].

Ophthalmological examination is part of a comprehensive examination in children under 4 years of age. Screening priorities are: strabismus examination at 10 months and 2 years of age; assessment of distant visual acuity at 2 years of age; assessment of monocular far and near acuity in association with colored vision screening at 4 years of age. Out of 130 000 check ups carried out by ophthalmologists in the Bilan de Santé de l'Enfant: At 10 months and 2 years of age: one child out of five presented ophthalmological anomalies of various degrees; At 4 years of age, one child out of four. One anomaly out of five required immediate treatment. Strabismus was noted in one child out of 28 for all ages considered. In the first year of age, the risk factors for ophthalmological anomalies were: prematurity, dysmaturity, neo-natal pathology, a familial past history of ophthalmic anomalies. These children must be routinely examined prior to the age of 2 years by an ophthalmologist trained in the examination of young children. The decision to refer to the ophthalmologist is the pediatrician's responsibility.