Vision Assessment

All immigrant children and youth can benefit from having their visual acuity (vision) assessed soon after arriving in Canada.  Loss of vision and undiagnosed sight-threatening eye diseases are more common among new immigrants and refugees than in the general population. Preventive screening by an optometrist or ophthalmologist can help identify visual impairment and strabismus for children younger than five years of age. Assessing for a red reflex and inspecting the external eye can begin when a child is a newborn.

Regionally prominent “tropical” eye diseases, such as onchocerciasis (river blindness), active trachoma and xerophthalmia, have not been reported in immigrants or refugees to Canada. Asymptomatic forms of these diseases should resolve or stabilize after the children arrive in Canada.

Implications

New immigrant children and youth should be screened for vision loss within their first year in Canada and should be referred to an optometrist or ophthalmologist if their vision is less than 20/40.1

1Pottie K, Greenaway C, Feightner J, et al. Evidence-based clinical guidelines for immigrants and refugees. CMAJ 2011;183:E824-925