Early detection of visual defects in infancy.

To determine the part played by screening in detecting visual defects questionnaires were sent to 240 families with blind or partially sighted children identified from the Family Fund's database. Questions were asked on social and family background, the visual disorder and its severity, any other disability, and how and when the disabilities were discovered and subsequently managed. Data from 189 families were analysed, constituting all those with children with major visual defects from the 219 families who replied. The visual defect was first discovered in 111 children by parents, friends, and neighbours, and in 36 by a doctor at the neonatal examination. In only three children who did not have a family history of visual impairment was the defect discovered during a formal screening examination at a child health clinic. Dissatisfaction about medical services was expressed by about a third of the parents, particularly a lack of provision of information and consideration of their worries and a failure to refer the child promptly to educational and treatment services. Visual defects in children under 5 are generally detected by family and friends, not by screening, but detection by the medical profession could be improved by increased awareness and observation and quick referral.