Unrecognised visual impairment in children with special educational needs

It is well known that there is a high prevalence of visual impairment in children in special schools and that correction will impact positively on learning. Woodhouse and colleagues report a survey of visual screening practices in Wales and the results of testing in schools where screening programmes were not in place. Screening was patchy (20/38 schools). Of the 173 children tested (five special schools with no screening in place, response to invitation, take up 31% although time limited study) 73/173 had never had an eye test. 17% had low vision by WHO criteria, six of whom had never previously had an eye test. Of the 172 tested for refractive errors 50% needed a first time (29/173) or updated prescription. Of the 46 children previously prescribed spectacles only 23 were wearing them on the day of the testing. More than half of the children (86/173) had some ocular abnormality that was either sight limiting or warranted action to prevent loss of sight. The authors rightly express concern regarding this dataset – patchy visual screening, undetected low vision, undetected refractive errors, failure to wear prescribed spectacles, high prevalence of ocular abnormalities in this vulnerable …