A new, more sensitive approach to clinically testing toddler’s vision and eye health is needed, say a team of international researchers that have looked at the relationship between mobility, motor skills and pre-school development of toddlers and their visual outcomes at 4.5 years of age.
The experts in vision and neonatal development found that the presence of astigmatism and abnormal motor function at two years of age may be associated with poorer vision at 4.5 years of age. In particular, abnormal motor abilities, such as inaccurate tracing, grasping and catching are warning signs, the researchers from Ireland, Australia, New Zealand, Hong Kong and Canada claimed in an article published in Ophthalmic and Physiological Optics.1
the researchers observed a direct correlation between poor motor scores at two years of age with a reduced ability to perceive depth (or 3D vision, known as ‘stereopsis’) at 4.5 years old
“Children who show poorer motor skills at an early age may benefit from comprehensive eye examinations to make sure these children get the best start to life, particularly with regard to reading and learning once they start school,” said senior author Flinders University Caring Futures Institute Professor Nicola Anstice in the article.
“Existing clinical tests for two-year-old children’s vision are not predictive of visual outcomes at 4.5 years, so we recommend the development of more sensitive tests for this,” she said, adding vision issues go undetected in an estimated one in four children.
Mild to moderate vision loss affects many children and can negatively impact a child’s early literacy and academic achievement, said first author Dr Nabin Paudel, from the Centre for Eye Research Ireland, and University of Auckland.
“Nevertheless, there is no consensus on which factors present in early childhood indicate the need for long-term ophthalmic follow-up, particularly in children with a history of perinatal adversity,” he said.
Using a longitudinal study of vision and neurodevelopmental milestones of a large cohort of 516 children at risk of perinatal adversity (Children with Hypoglycaemia and their Later Development (CHYLD) project), the researchers observed a direct correlation between poor motor scores at two years of age with a reduced ability to perceive depth (or 3D vision, known as ‘stereopsis’) at 4.5 years old.
This study identified the relationship between visual, cognitive, motor and demographic factors at two years of age and visual acuity (VA) and stereoacuity at 4.5 years of age – paving the way for development of a new approach in ophthalmic practice in the future, the paper concludes.
Interestingly, the CHYLD project previously found that children with neonatal hypoglycaemia were no more likely to have vision or physical development problems than children without neonatal hypoglycaemia.
The research was supported by grant R01HD069622 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, by grant 10-399 from the Health Research Council of New Zealand, by the Auckland Medical Research Foundation (1110009), and by Gravida, National Research Centre for Growth and Development, NZ.
A team led by Professor Anstice is now investigating vision screening for South Australian school children aged seven to nine years for prevalence of vision disorders and to establish the best tests to use for identifying primary school children with vision disorders.
- Nabin Paudel, Benjamin Thompson, Arijit Chakraborty, Jane Harding, Robert J Jacobs, Trecia A Wouldes, Sandy TY Yu and Nicola S Anstice (on behalf of the CHYLD Study Team). Relationship between visual and neurodevelopmental measures at two years with visual acuity and stereopsis at 4.5 years in children born at risk of neonatal hypoglycaemia (2021). Ophthalmic and Physiological Optics (Wiley) journal DOI: 10.1111/opo.12910.