Vision problem: Comprehensive eye examination for children needed, say experts

CHILDREN should undergo a comprehensive eye examination prior to starting school to detect any vision problems or eye diseases, which, if left untreated, may take a toll on their development.

Childcare experts, parents and teachers agree that a national policy should be in place to make eye screening compulsory for children prior to their admission to Year One.

Early Childhood Care and Education Council president Professor Datuk Dr Chiam Heng Keng said early intervention was crucial to ensure a child’s development and wellbeing.

“Good hearing and vision contribute to children’s ability to learn,” she said, adding that poor vision affected children’s balancing, kinetic and other physical abilities, as well as social skills, emotional development and cognitive or intellectual abilities.

“Parents need to identify early signs that their children exhibit, such as squinting their eyes, tilting their head when trying to listen, or showing poor coordination while playing with their toys.

  “Rather than dismissing these symptoms as mere acts of clumsiness and consequently, scolding the children, parents and caretakers need to see that these are telltale signs that the children need help,” she told the New Sunday Times.

Dr Chiam said some children with vision problems were erroneously dismissed as having disciplinary issues or learning disabilities, and often reprimanded for not following instructions or making too many mistakes.

She said teacher training modules should include basic indicators of children with hearing and vision problems and expressed her support for the call for children to undergo comprehensive screening before starting school.

National Early Childhood Intervention Council (NECIC) president Dr Wong Woan Yiing said compulsory eye screening at an early age was required to curb permanent vision impairment and prevent developmental delays.

 She said Malaysia had limited data on the prevalence of visual disorders among children but internationally, studies had shown that 20 per cent of all children had refractive errors, amblyopia or squinted.

“Studies also showed that nearly eight per cent of childhood blindness are potentially preventable and another 43 per cent treatable.

“Even when refractive errors are mild, there’s a risk of developing amblyopia and permanent visual impairment.”

Malaysian Medical Association president Dr John Chew said random health screenings by the Health Ministry were carried out at the primary school level in cooperation with the schools’ Parent-Teacher Associations since not all children attend preschools.

“I support the call to have more programmes for children so that we can identify problems in regards to their vision at an early stage.”

Former NECIC president Datuk Dr Amar Singh said there was a need to push for routine screening of eye problems in children before school entry, around the age of 4 and 5.

“This will allow us to detect many of the refractory errors. Screening at the primary school level is a bit late and some problems may not be remediable.

“Eye screening is best done by the Health Ministry.

“Parents who are more aware should be on the lookout
for problems and seek help
early,” said the senior
consultant paediatrician.

NECIC project officer Ng Lai Thin said teachers and parents needed to be aware of the warning signs of vision problems in young children, such as squinting and holding books too closely to their eyes.

“Parents should help prepare their children prior to their eye exams, as they may be scared or nervous.

“Similarly, more public health education programmes for parents and teachers should be made available to help them understand these health issues better,” she said.

 Parent Action Group for Education chairman Datin Noor Azimah Abdul Rahim attributed children’s vision problems today to spending an excessive amount of time looking at the bright screens of tablets, computers and mobile phones.

“Additionally, parents must ensure that there is sufficient light in the room where their children read and write,” she said.

She said teachers could help identify children with potentially poor eyesight and encourage the use of caps and protective eyewear during outdoor sporting activities.

“There should also be more campaigns to raise awareness on eye care,” she said, adding that children today were more prone to cataracts due to poor lifestyle, a problem that was traditionally age-related.

National Union of Teaching Profession president Kamarulzaman Abdul Razak supported the call to make eye screening mandatory at the preschool level nationwide, including private schools.

For homeschooled preschoolers, he said, parents should ensure that their children undergo eye exams prior to Year One.

Deputy Education Minister Datuk P. Kamalanathan hoped the result of the Segamat Paediatric Eye Disease Study could be sent to the Health Ministry soon to determine the next course of action.

He said more studies on the prevalence of eye problems
in children needed to be carried out before the government
could make any decision on making eye screening compulsory in schools.

“To conduct a nationwide school programme, we need more studies to be carried out on such a programme, including the mechanisms for its implementation.

“The next step, once this is done, is for a multi-ministry effort to be carried out,” he told the New Sunday Times.

He said the ministry was ready to play its part to ensure the wellbeing of schoolchildren.

Currently, he said, eye check-ups were conducted on an ad hoc basis by the Health Ministry as part of a total check-up following an invitation by the schools or their Parent-Teacher Associations.

“Parents and teachers can play a more proactive role by identifying those showing signs of having visual problems and seeking treatment for the children if necessary.” Reporting by Tharanya Arumugam