Current and future strategies to prevent childhood visual impairment in Britain
| Primary prevention |
|---|
| Strategy (examples of target disorders) |
| Prevention of prenatal infections such as rubella and prenatal exposure to known teratogens such as drugs and alcohol. |
| (optic nerve hypoplasia, coloboma, microphthalmos, cataract) |
| Provision of preconceptional genetic counselling to families with known hereditary eye disease. |
| (retinal dystrophies, microphthalmos, cataract, glaucoma) |
| Further development and future provision of prenatal diagnostic tests and possible gene therapies for inherited eye diseases. |
| (retinal dystrophies, retinoblastoma) |
| Promotion and further development of strategies to reduce low birth weight and preterm birth. |
| Avoidance of known perinatal insults such as hypoxia. |
| (retinopathy of prematurity, cortical visual impairment, optic atrophy) |
| Screening of children at high risk of specific disorders: preterm infants, specific systemic diseases, for example juvenile chronic arthritis, diabetes. |
| (retinopathy of prematurity, uveitis, retinopathy) |
| Secondary prevention |
| Early detection through child health surveillance to ensure prompt referral of all children with ocular disorders. |
| Early detection through routine ophthalmological assessment of children at high risk, for example family history of eye disease; those with hearing impairment, neurodevelopmental or neurological disorders. |
| Assessment and management of children with serious visual loss by specific multidisciplinary teams. |
| Tertiary prevention |
| Assessment of special educational needs and appropriate educational placement. |
| Assessment for, and provision of, low vision aids and rehabilitation services to optimise residual vision of children with disorders not amenable to specific treatment |
| (congenital eye anomalies, retinal dystrophies) |
| Partial sight or blindness registration to maximise access to appropriate services |