Rates of spectacle wear in early childhood in the Netherlands.

BACKGROUND: Refractive errors are relatively common all around the world. In particular, early onset myopia is associated with a significant burden in later life. Little is known about refractive errors in preschool children. The aim of this study was to assess the prevalence of spectacle wear, visual acuity and refractive errors in young Dutch children. METHODS: We analyzed data of three prospective population-based studies: 99,660 3- to 5-year-olds undergoing vision screening at preventive child healthcare organizations, 6934 6-year-olds from the Generation R study, and 2974 7-year-olds from the RAMSES study. Visual acuity was measured with Landolt-C or LEA charts, spectacle wear was assessed, and refractive errors at age 6 and 7 were measured with cycloplegic refraction. RESULTS: The prevalence of spectacle wear ranged from 1.5 to 11.8% between 3 to 7 years with no significant gender differences. Among children with spectacle wear at 6 years (N = 583) and 7 years (N = 350) 29.8 and 34.6% had myopia respectively, of which 21.1 and 21.6% combined with astigmatism; 19.6 and 6.8% had hyperopia, 37.2 and 11.1% hyperopia and astigmatism, and 12.5 and 32.7% astigmatism only. CONCLUSIONS: Spectacle wear in European children starts early in preschool and increases to a relatively frequent visual aid at school age. Advocating early detection and monitoring of refraction errors is warranted in order to prevent visual morbidities later in life.

[Outdoors of course!] / Natuurlijk naar buiten!

Outdoor play makes children healthier. An active lifestyle is particularly important for optimal growth and development of children. Restrictions due to the Corona virus make this more apparent. The professional network 'View Outside' collected the lifestyle consequences for visual, motoric, postural, weight, sleep and psychosocial youth health. We strongly recommend spending two hours a day outdoors, of which a minimum of one hour should be at least moderately intensive exercise. Other lifestyle measures are reducing sedentary behavior, rules on screen use and regular change of activities when sedentary.

[Demedicalisation within youth healthcare: the role of the youth healthcare doctor]. / 'Demedicalisering' in de jeugdgezondheidszorg: de rol van de jeugdarts.

The Dutch Youth Act (2015) has to resolve serious problems among young people, prevent inappropriate medicalisation, and realise efficiency. Participation and empowerment are terms often used. At the moment Dutch youth healthcare doctors monitor children on a regular basis and assess situations based on the national Public Health Status and Forecast Report (PHSF; VTV in Dutch) 'health field' context model. We discuss two children with behavioural problems at school and at home. Based on a detailed analysis and after excluding medical issues, in the first case the youth health care doctor advised participation in a sporting activity for those of limited financial means, and in the second case, the child was not referred for psychiatric consultation as simple adjustments at school were sufficient. The VTV 'health field' context model which Dutch youth health care doctors apply, links medical knowledge with the detection of non-medical issues. This expertise, combined with the knowledge of potential local intervention measures, can result in improved participation at home and at school. It is important that the family physician and other medical specialists recognise this expertise.

The Bruckner test variant (BTV): a promising instrument in detecting vision disorders.

BACKGROUND AND PURPOSE: In the Netherlands, children are screened for amblyopia based on the early detection of visual disorders (VOV) protocol by child health care physicians. The positive predictive value (PPV) of the Brückner test variant (BTV) as an alternative method was assessed. PATIENTS AND METHODS: In this historical prospective analysis, the results of the VOV and BTV methods were compared. Results at the ages of 15 and 27 months of 414 children were compared against diagnosis by the ophthalmologist; follow-up was at 72 months. RESULTS: Visual disorders were found in 12 of 15 children (14 had an abnormal BTV) who underwent ophthalmological examination. The PPV of the BTV was 86%; 12 of the 14 children with an abnormal BTV had a vision disorder in the preverbal phase. CONCLUSION: The BTV is superior to the VOV method in the early detection of vision disorders and could be a cost-effective public health intervention.