From our friends at The Elks Children’s Eye Clinic Preschool Vision Screening Program

The Oregon Elks Preschool Vision Screening Program was established in 2003 to detect preventable vision loss in children. In partnership with the Oregon State Elks Association, the Oregon Elks Children’s Eye Clinic at OHSU, and the Oregon Head Start Association, thousands of Oregon children are screened each year for eye problems. Hundreds are referred for a complete eye exam. Follow up on the eye exams indicate that at least 15 percent of all preschool children need to be treated for eye problems.

Why Perform Preschool Vision Screenings?

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To detect preventable vision loss in children. Some vision disorders can be reversed if treated before age 5.

Undetected vision problems in children are common, yet if your child’s eyes are straight and are not crossed, your child’s vision problem may go unnoticed. This is especially true in young children who do not complain of blurry vision. This is because a blurry world is normal to them. An objective vision screening is the best way to detect a vision problem in preschool children. Unfortunately, there is a lack of public awareness of how important it is to detect a vision problem while the visual system is developing. In the United States, very few preschool children receive a vision screening during the critical window of visual development. Ideally, a child’s pediatrician would provide an annual vision screening using an objective vision screening methodology, such as photoscreening. The results would be part of the child’s medical record, and all follow-up eye exams would be monitored by the pediatrician. Unfortunately, most preschoolers do not receive a vision screening from their pediatrician during their 10-minute well-child check. If they do, it is often performed with an outdated chart.

Why Do Children Lose Vision?

Amblyopia is the number one reason why children lose vision.

What Is Amblyopia? \am-blē-`ō-pē-ə\

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A central nervous system disorder that develops when the brain and the eye are not working together, amblyopia is usually caused by unequal focusing power, misaligned eyes, or blockage of vision.

Amblyopia Affects 5 percent of Preschool Children

Only children can get amblyopia. It can develop in the first few years of life if one eye is not getting enough use. Amblyopia often goes undetected in children with straight eyes.

Earlier Is Better

  • School age screening may be too late.
  • Amblyopia is difficult to treat after age 5. (American Association for Pediatric Ophthalmology and Strabismus, known as AAPOS)
  • Permanent vision loss occurs by age 7. (AAPOS)
  • Children entering kindergarten with amblyopia are not prepared to learn.
  • 80 percent of learning in the first years comes through vision.
  • Undetected vision disorders can lead to developmental delays.
  • Behavior problems may be undiagnosed vision problems.

Treating Amblyopia

Children who are referred after a vision screening need to be seen by an eye doctor to receive a full comprehensive dilated eye exam. Treating amblyopia involves strengthening the weaker eye. This can be done by patching the strong eye for several hours a day or by placing a drop in the better eye to blur vision, forcing the use of the weaker eye. Successful treatment of amblyopia depends on how early it is detected.

More Resources Available

Additional information and educational resources are available online. The Elks Preschool Vision Screening Program offers a list of eye doctors who accept OHP patients and are willing to provide comprehensive dilated eye exams for preschool children. Learn more here.

Oregon State Elks

Thanks to generous donations from the Oregon State Elks, the program provides vision screenings at Oregon Head Start preschools, libraries, and public health fairs across the state. Oregon Elks volunteers from the local Elks lodges volunteer their time to assist with the screenings. Since 1949, the Oregon Elks have donated over $50 million and countless hours of service to provide the gift of sight to thousands of Oregon children.


What Causes Amblyopia?

Unequal Focusing Power

Unequal focusing power is the most common cause of amblyopia, but it is difficult to detect. The child’s vision will be blurred, but their eyes will appear straight. Children with this condition who are not treated before age 7 are likely to lose use of their weaker eye.

Crossed Eyes

Strabismus, often referred to as crossed eyes, is a vision disorder where the eyes are not aligned in a similar direction. One or both eyes may be turned inwards, up, down, or outwards. The eyes will focus on different fields of view, causing confusion. If left untreated, the brain may learn to ignore the weaker eye in response to this confusion, resulting in amblyopia.

Blocked Vision

Vision can be completely blocked by a cataract or droopy lid. The eye is prevented from developing because it sees no images. These conditions must be corrected, usually with surgery, as quickly as possible so amblyopia treatment can begin.

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