Challenges in the exploration of the visual function in small children

Unlike other sensory systems in humans, the visual system is very immature at birth, and gradually develops during the first months and years of life. The first years of early childhood, spanning until three years of age, are a critical window for the development of a human being. Most of the information an infant receives during the first years of life comes from the visual system. This information is the starting point of a complex brain integration process for the development of perceptual, cognitive, motor, and social abilities. This is why visual deficiencies that are undiagnosed in childhood can have severe consequences not only in the visual function, but also in the general development of the child.

The World Health Organization estimates there are 19 million children in the world with visual problems. Due to the limitations in current diagnosis mechanisms, many of those children will not be diagnosed until they are four or five years old. Surprisingly, between 70 and 80% of those visual problems could have been treated or cured if they had been detected early enough. In certain settings, up to 60% of children going blind will die during the following two years. These facts expose the need for effective surveillance systems capable of early detection of any sign of suboptimal development.

Traditional visual exploration - visual acuity test
Ophthalmologist performing a visual acuity test with a traditional visual exploration mechanism

Exploration of the visual function in small children, babies, and patients with neurocognitive disorders is currently a complex challenge for ophthalmologists, because they are non-collaborative patients. Traditional visual tests cannot be used with those patients, since they are designed for collaborative adults with normal cognitive and motor development. Instead, doctors use analog tests that individually explore certain basic aspects of the visual function. Those tests require great ability and experience from the ophthalmologist, because he has to estimate the visual function quality of the infants from their behaviour when presented with different visual stimuli. For that reason, those analog tests provide inaccurate and subjective results with low repeatability. Besides, there are no mechanisms to explore many aspects of the visual function in those children, such as color perception or visual field. Therefore, it is impossible to determine certain visual abilities in patients younger than four or five years of age, or in older patients with neurocognitive disorders. 

The DIVE device has been developed to enable precise and objective exploration of the visual function in non-collaborative patients, helping doctors with early diagnosis and treatment of visual problems in small children and babies.