Contrary to official recommendations, children with a common eye disorder called amblyopia – where one eye does not see properly despite wearing glasses – have a better chance of becoming cured if treatment starts before three years old, according to results from the Children of the 90s study at Bristol University.
Affected children would therefore be less likely to be barred from jobs where good sight in both eyes is necessary, such as pilots, some police forces and various engineering careers. They would also have less risk of major disability if they were to lose their good eye.
Research was carried out amongst families who are part of the Avon Longitudinal Study of Parents and Children, popularly known as the Children of the 90s study. Two thousand children were either offered repeated eye tests between 8 months and 3 years old (before-3 group) or their sight was tested only when they reached 3 years old (the at-3 group).
Any children found to have amblyopia were referred to the local eye hospital for treatment. By the time these children were 7 ½ years of age, the before-3 group had far fewer children with persistent amblyopia than those who had only been tested at 3 years old for the condition (0.6% versus 1.8%).
Those whose eye problem had been picked up earlier than 3 years old, and had received treatment for it using eye patches early on in their lives, were four times more likely to be cured of their condition than those who had been diagnosed at 3.
Since a report in 1997 from the NHS Centre for Reviews and Dissemination at the University of York (CRD Report 9) found that there was no evidence that early treatment worked better than treatment at school age, tests for pre-school children have been discontinued. This has caused widespread debate and disagreement between professionals and highlighted the need for more research. New recommendations have since been published suggesting tests at 4 to 5 years of age should be offered to all children, pending further evidence.
Dr. Cathy Williams, the eye doctor who led the ALSPAC research, says, “Whether the state should offer vision testing for preschool children has been hotly debated since the 1997 report. We hope our findings will stimulate further investigation as to whether testing before 3 could be offered, which could well lead to better sight for children who need treatment for amblyopia.”
Notes
The article ‘Amblyopia Treatment Outcomes After Screening before three years versus at three years – follow-up from randomised trials. C Williams et al’ appeared in the BMJ (British Medical Journal) June 29th, 2002. doi: 10.1136/bmj.324.7353.1549
ALSPAC The Avon Longitudinal Study of Parents and Children (also known as Children of the 90s) is a unique ongoing research project based in the University of Bristol. It enrolled 14,000 mothers during pregnancy in 1991-2 and has followed most of the children and parents in minute detail ever since.