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The article focuses on a research which explores the screening and diagnostic outcomes of the state-funded New South Wales Statewide Eyesight Preschooler Screening program for 4-year-old children. It mentions the importance of early detection and treatment to achieve optimal treatment outcomes for children with vision disorders. The methods used in the research are mentioned.

PURPOSE : Todescribe the prevelance and associations with common eye conditions (refractive errors, anisometropia, amblyopia, strabismus), in a sample of younger and older school children attending primary and secondary schools in Sydney, Australia. METHODS : The Sydney Childhood Eye Study is a population based survey of a sample of Year 1 and Year 7 school children resident in the metropolitan area of Sydney, Australia. Of the 2238 eligible Year 1 students 1760 (78.9%) participated (mean age 6.7 years), while of the 3130 eligible Year 7 students 2353 (75.1%) participated, (mean age 12.7 years). Ethnic groups included European Caucasian (63%) and East Asian (17%) children. The comprehensive eye examination included corrected and un-corrected log MAR visual acuity, cover testing, assessment of ocular movements, tests for stereopsis, color vision, auto-and subjective refraction, ocular biometry, slit lamp examination, optical coherence tomography and mydriatic digital retinal photography. RESULTS : Prevalence rates for myopia and moderate hyperopia were 1.5% and 13.2%, respectively, for the younger group, with corresponding prevalences of 12.8% and 20.9%, respectively, for the older group. Rates of bilateral and unilateral visual impairment (with best correction) were 0.9% and 2.8% in the 6-year old children (caused by uncorrected astigmatism and amblyopia), while for the 12 - year old children, corresponding rates were 1.1% and 5% (80% correctable by refraction), most noncorrectable impairment was due to amblyopia. Amblyopia was present in 1.8% of the younger and 1.9% of the older group (of whom 60% and 73%, respectively, had been successfully treated). Strabismus was present in 2.8% of the younger and 2.7% of the older group, and was associated with gestational parameters, refractive errors, particularly hyperopia and amblyopia. An anisometropia, of at least 1 dioptre was present in 1.6% of the younger group and was strongly related to amblyopia and strabismus. CONCLUSIONS : Data from this study of two age groups of school children has defined the prevalence of common childhood eye disorders causing impaired vision. [ABSTRACT FROM AUTHOR]

Purpose: The aim was to investigate universality of access, screening rate, and outcomes from the New South Wales (NSW) Statewide Eyesight Preschooler Screening (StEPS) over the period of 2009 to 2016., Design: Cross-sectional, observational study., Methods: The StEPS program provides vision screening to 4-year-old children residing in NSW and is administered within Local Health Districts (LHDs). Visual acuity (VA) was examined by trained lay and nurse screeners using HOTV logMAR. Children who had VA <6/9-2 were referred to local practitioners while those with VA <6/18 were referred to public hospital pediatric ophthalmic outpatient clinics where available. Activity data were collected by NSW Health and screening rates determined from population projections of 4-year-olds per LHD based on adjusted 2014 Census data. To determine factors impacting screening and referral rates, a random effects panel analysis was undertaken., Results: A total of 719,686 (96.4%) NSW 4-year-old children were offered StEPS vision screening between 2009 and 2016, 84% accepted and 564,825 children (75.6%) were screened. The screening rate increased from 67.3% in 2009 to 74.5% in 2016, with an 80% target reached for 3 consecutive years from 2013 to 2015. Of those screened, 19.2% were referred to an eye health professional or advised to have a vision retest in 12 months. This referral rate remained steady over the period studied, with little variation between metropolitan, and rural and regional LHDs., Conclusions: StEPS is an ideal service model for preschool vision screening providing coverage that is comparable to school-based screening programs and at an age likely to facilitate optimal treatment outcomes., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2022 Asia-Pacific Academy of Ophthalmology. Published by Wolters Kluwer Health, Inc. on behalf of the Asia-Pacific Academy of Ophthalmology.)

Background: To report the 31-year experience of outcomes in retinoblastoma from a single centre., Methods: A retrospective analysis of consecutive cases of retinoblastoma diagnosed and treated at the Westmead Children's Hospital, Sydney between 1974 and 2005 was performed. The subjects were analysed as two groups: those diagnosed between 1974 and 1989 (series alpha) and those diagnosed between 1990 and 2005 (series beta)., Results: There were a total of 142 patients included in the study, with a median follow up of 72 months. There were 84 patients with unilateral disease and 58 patients (116 eyes) with bilateral disease. The total enucleation rate remained high throughout both series for those with unilateral disease: 89% (series alpha) and 95% (series beta). There was a reduction in enucleations performed for those with bilateral disease from 68.4% (series alpha) to 43.6% (series beta) (P < 0.025). There were no bilateral enucleations performed after 1995. Actuarial Kaplan-Meier curves showed that 56% of all preserved eyes had not recurred at a median follow up of 95 months and 78.1% had avoided enucleation. Overall 43% of preserved eyes attained a visual acuity better than or equal to 6/12 and 55% achieved a visual acuity better than 6/60. There were four deaths due to retinoblastoma. Five patients were diagnosed with a second non-ocular malignancy. The most common treatment-related complications were cataracts, facial deformity, sepsis and febrile neutropaenia., Conclusions: The introduction of newer globe-preserving treatments for retinoblastoma was associated with equivalent visual outcomes, stable mortality rate and a greater number of short-term complications but avoided the late side-effects associated with external beam radiotherapy.

Background: To assess the prevalence and causes of visual impairment in patients with craniosynostotic syndromes of Apert, Crouzon, Pfeiffer, Saethre-Chotzen and craniofrontonasal dysplasia., Methods: The medical records of patients who attended the Craniofacial Clinic at two large paediatric hospitals in Sydney, Australia between 1983 and 2004 were retrospectively reviewed. Presenting visual acuity (VA) was assessed using tests appropriate to age and cognition: 'fix and follow' in infants (<18 months old), Teller card acuity in preverbal children (18 months to less than 3 years old), Kay picture test or Sheridan-Gardiner test in children aged between 3 and less than 6 years and Snellen chart in those aged 6 years or older. Visual impairment was defined as the inability to fix and follow or presenting VA < 6/12 in the better eye. Amblyopia was defined as a two-line difference in VA between both eyes in the absence of an organic eye disease., Results: Sixty-three patients with craniosynostotic syndromes were identified, of whom 55 had VA assessed at the first visit. Of these 55, 19 (35.5%) had bilateral visual impairment and 5 (9.1%) had unilateral visual impairment. Causes of visual impairment include amblyopia (16.7%), ametropia (25%), optic atrophy (16.7%) and exposure keratopathy (4.2%). Risk factors for amblyopia include strabismus (43.3%), astigmatism (> or =1.5 dioptres) (39.5%), hypermetropia (18.4%) and anisometropia (> or =1.5 dioptre difference between both eyes) (15.8%). Six of the 63 patients (9.5%) had papilloedema; those who were followed up showed gradual resolution of papilloedema following timely decompressive surgery., Conclusions: A high prevalence of visual impairment in patients with craniosynostotic syndromes was found, almost half of them due to potentially correctable causes, including amblyopia and ametropia. Optic atrophy remains an important cause of visual impairment. Further studies are needed to assess the timing and efficacy of intervention for modifiable causes of visual loss in craniosynostotic syndromes.

Objectives: To describe the prevalence of amblyopia and associated factors in a representative sample of 6-year-old Australian children., Methods: Logarithm of minimum angle of resolution visual acuity (VA) was measured in both eyes before and after pinhole correction, correcting cylindrical refractive components greater than 0.50 diopter (D), and with spectacles (if worn) in a population-based sample of 1741 schoolchildren. Retinal pathological abnormalities were excluded based on photographs. Amblyopia was defined using various best-available corrected VA measures in the absence of significant organic pathological abnormalities., Results: Using the criteria of corrected VA less than 20/40 and at least a 2-line difference between eyes, amblyopia was diagnosed in 13 children (0.7%). The inclusion of children with amblyopia who had been successfully treated (n = 19) increased the amblyopia prevalence to 1.8%. Strabismus or strabismus surgery history was present in 37.5% of the children with amblyopia, anisometropia in 34.4%, both conditions in 18.8%, and isoametropia in 6.3%. Mean corrected VA in amblyopic eyes was 37.7 logarithm of minimum angle of resolution letters (Snellen VA equivalent < 20/40), ranging from 0 to 48 logarithm of minimum angle of resolution letters (Snellen VA equivalent < 20/200-20/25). Most amblyopic eyes (58.7%) were significantly hyperopic (spherical equivalent > or = +3.00 D); 8.7% were myopic., Conclusions: A relatively low prevalence of amblyopia in a sample of 6-year-old children is documented. The majority of these children had already been diagnosed and treated for this condition.

Purpose: To study the distribution of spherical equivalent refraction and ocular biometric parameters in a young Australian population., Methods: Noncontact methods were used to examine ocular dimensions and cycloplegic autorefraction in a stratified random cluster sample of year 1 Sydney school students (n = 1765), mean age 6.7 years (range, 5.5-8.4 years). Repeated measures of axial length, anterior chamber depth, and greatest and least corneal radius of curvature (CR1, CR2, respectively) were taken in each eye. Refraction was measured as the spherical equivalent., Results: Mean spherical equivalent refraction in right eyes was +1.26 +/- 0.03 D (SEM; range, -4.88 to +8.58). The distribution was peaked (kurtosis 14.4) and slightly skewed to the right (skewness, 1.7). Prevalence of myopia, defined as spherical equivalent refraction < or = -0.5 D, was 1.43% (95% CI, 0.94-2.18) in the overall population. Axial length, anterior chamber depth, and corneal radii of curvature were normally distributed. The mean axial length in right eyes was 22.61 +/- 0.02 mm (SEM; range, 19.64-25.35). The mean anterior chamber depth was 3.34 +/- 0.01 mm (SEM; range, 2.14-4.06). Mean CR1 was 7.85 +/- 0.01 mm (SEM) and mean CR2 was 7.71 +/- 0.01 mm (SEM). The distribution of axial length/mean corneal radius ratio was peaked (leptokurtic) with a mean of 2.906. Mean axial length was longer, anterior chambers were deeper, and corneas were flatter in the boys., Conclusions: A peaked (leptokurtic) distribution of spherical equivalent refraction was present in this predominantly hyperopic 6-year-old population. The results also showed that ocular biometric measures were normally distributed, with statistically significant gender differences found in measurements.

Purpose: The aim of this study was to retrospectively review uveitis cases at The Children's Hospital at Westmead, Sydney, since its inception in 1997 to 2001, including patients presenting at the Camperdown, Sydney, campus between 1989 and 1997 attending Westmead for further care. Comparison is made with international centres., Methods: Information was obtained from medical records., Results: Forty patients (53 eyes) presented, of whom 23 (57.5%) were female and 17 (42.5%) were male (mean age 6.7 years). Of 53 eyes, 35 (66%) had anterior uveitis, three (5.7%) intermediate uveitis, seven (13.2%) posterior uveitis and eight (15.1%) panuveitis. Twenty-seven (67.5%) patients had disease unilaterally and 13 (32.5%) bilaterally. Twenty-four (60%) cases were idiopathic. Seven (17.5%) cases were associated with juvenile rheumatoid arthritis, three (7.5%) with herpes zoster, two (5%) with herpes simplex, two (5%) with toxocara, one (2.5%) with toxoplasma, and one (2.5%) with ulcerative colitis. Complications included cataract in 14 (26.4%) eyes; band keratopathy in four (7.5%) eyes; macular scarring in three (5.7%) eyes; and glaucoma in four (7.5%) eyes. Last measured acuity was 6/6 for 19 (35.8%) eyes, < or =6/18 for 15 (28.3%) eyes and <6/60 for eight (15.1%) eyes., Conclusions: Despite small numbers, the comparisons of this study with some international studies, and its contrasts with other studies, are due to similarities and differences amongst these studies with respect to factors of referral bias, and the aetiological basis of disease.