Evaluación de los ojos en niños

American Academy of Ophthalmology Pediatric Ophthalmology/Strabismus Panel. Pediatric eye evaluations: I. Screening; II. Comprehensive ophthalmic evaluation. San Francisco (CA): American Academy of Ophthalmology; 2007. 32 p.

Describe los metidos clínicos de cribado de la visión y los problemas oculares, los aspectos más relevantes de la anamnesis para detectar problemas oftalmológicos en atención primaria y los factores de riesgo detectados que son criterio de derivación al especialista:

INDICATIONS FOR REFERRAL FOR A COMPREHENSIVE PEDIATRIC OPHTHALMIC EVALUATION
Risk factors (general health problems, systemic disease, or use of medications that are known to be associated with eye disease and visual abnormalities):
• Prematurity (birthweight less than 1500 grams or gestational age 30 weeks or less)
• Retinopathy of prematurity
• Intrauterine growth retardation
• Perinatal complications (evaluation at birth and at 6 months)
• Neurological disorders or neurodevelopmental delay (upon diagnosis)
• Juvenile idiopathic arthritis (upon diagnosis)
• Thyroid disease
• Cleft palate or other craniofacial abnormalities
• Diabetes mellitus (5 years after onset)
• Systemic syndromes with known ocular manifestations (at 6 months or upon diagnosis)
• Chronic systemic corticosteroid therapy or other medications known to cause eye disease
• Suspected child abuse
A family history of conditions that cause or are associated with eye or vision problems:
• Retinoblastoma
• Childhood cataract
• Childhood glaucoma
• Retinal dystrophy/degeneration
• Strabismus
• Amblyopia
• Eyeglasses in early childhood
• Sickle cell anemia
• Systemic syndromes with known ocular manifestations
• Any history of childhood blindness not due to trauma in a parent or sibling
Signs or symptoms of eye problems by history or observations by family members* :
• Defective ocular fixation or visual interactions
• Abnormal light reflex (including both the corneal light reflections and the red fundus reflection)
• Abnormal or irregular pupils
• Large and/or cloudy eyes
• Drooping eyelid
• Lumps or swelling around the eyes
• Ocular alignment or movement abnormality
• Nystagmus (shaking of eyes)
• Persistent tearing, ocular discharge
• Persistent or recurrent redness
• Persistent light sensitivity
• Squinting/eye closure
• Persistent head tilt
• Learning disabilities or dyslexia
NOTE: These recommendations are based on panel consensus.
* Headache is not included since it is rarely caused by eye problems in children. This complaint should first be evaluated by the primary care physician.