Abstract:
Purpose: Limited data are available on the causes of visual impairment in New Zealand children. We aimed to review demographic and visual parameters in children referred to the Eye Department from preschool vision screening programs in South Auckland. Methods: Retrospective record review to determine reason for referral, findings from ophthalmic assessments, treatment received and visual acuity (VA) at final visit. The main outcome measures were cause of visual impairment and VA at the final assessment. Results: 131 children, aged 3-5, were referred from community vision screening programs to the Eye Department for further assessment. The main causes of visual impairment were refractive error (37.4%), amblyopia (22.1%) and strabismus (7.6%). Children with refractive error had good visual outcomes with an average final VA of 0.167 ± 0.077 logMAR units. In amblyopic children, refractive correction alone was the most common therapy (n=18), while 7 children also received occlusion therapy, 1 child additional atropine penalization and 3 children a combination of refractive correction, atropine and patching. Compliance with amblyopia therapy was poor with 48.3% non-compliance to the prescribed treatment regimen. Despite this, there was a significant improvement in VA in the amblyopic eye (p < 0.001) with an average final VA of 0.294 ± 0.231 logMAR (Snellen 6/12). Children with strabismus had worse visual outcomes with a final VA of 0.517 ± 0.422 in the strabismic eye. A significant number of children (n = 38) were discharged after the initial hospital assessment as false positive referrals. Conclusions: Refractive error was the most common cause of visual impairment in children referred to the Eye Department. Good acuity was achieved in the majority of children who received refractive correction and additional amblyopia therapy if required.
