Visual difficulties can manifest in different ways in children, with screening in children generally being quite easy and readily accessible.
See also the Royal Children's Hospital pre-referral guidelines.
Vision difficulties can manifest in different ways in children and should be considered in the following circumstances:
- poor fixing and following at 6-8 weeks of age
- roving eye movements
- poor fine motor development in infants
- learning difficulties, poor school performance or school related behavioural problems
- persistent headaches
Visual disturbance can also be the presenting sign of or an association with various medical problems:
- neurological problems including seizures
- benign intracranial hypertension
- increased intracranial pressure
- neurological disorders/syndromes and global developmental delay
- cerebral palsy
- Visual difficulties should be suspected in children with poor fine motor development, learning difficulties, school related behavioural problems or persistent headaches.
- Visual disturbance can also be the presenting sign of various medical problems.
- Red flags in children presenting with visual disturbance that warrant urgent referral include sudden onset visual changes, 6th cranial nerve palsy (limited abduction of affected eye), nystagmus and/or diplopia, morning vomiting and/or headache.
- sudden onset of persisting visual difficulty
- new onset 6th cranial nerve palsy (limited abduction of affected eye)
- nystagmus and/or diplopia
- morning vomiting and/or headache
- Optometrist or ophthalmologist
- Community based optometry services are appropriate for initial assessment of vision in most children
- Referral to an ophthalmologist should be considered first if the child is particularly young (< 12 months) or there are associated neurological concerns.
- Ballarat Health Services - public ophthalmology clinic
- Ballarat Eye Clinic - private opthalmology clinic
- Referral to emergency services or early discussion with paediatric services is advisable when any red flags are present (see above).
- Referral to paediatric outpatient services is not appropriate for the assessment of the majority of isolated visual disturbances in children.
- Referral to paediatric outpatient services is advisable when there are concerns suggesting an underlying medical diagnosis in the setting of visual disturbance.