Visual problems in children: detection and referral.

A study was made of 151 children referred to orthoptic clinics for suspected squint or suspected impairment of visual acuity. In only 50 children was there no abnormality. The contribution of different branches of the health service to detection and referral was measured. Parents and general practitioners were found to have an important role in early detection and referral, but there remained an important group of 19 children with squints undetected by their parents.There was some evidence of delay in referral, with less than half of the children with true squint being seen by a specialist within six months, and the reasons for this are discussed in terms of parents' and doctors' understanding of visual problems in children. Delay is discussed in relation to the complexity of services for child health and to recent proposals for the integration of paediatric surveillance in general practice.