Challenges in the detection of visual pathologies 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

Population-based visual screening programs in infancy, carried out by pediatricians, optometrists or other specialists, are the main tool to avoid undetected visual disorders and late diagnosis. Currently, early detection of visual problems in small children, babies, and patients with neurocognitive disorders is a major challenge, which limits any visual screening program in infancy. Common visual tests are mostly designed for adult patients with normal cognitive and motor development. It is not possible to use these tests in children younger than three or four  years of age, or with developmental issues. For this reason, only basic and subjective visual exploration tests, highly dependent on the experience of the examiner, can be performed on those children.

The DIVE device has been developed to enable precise and objective exploration of the visual function even in non-collaborative patients, helping doctors with early diagnosis and treatment of visual problems in small children and babies. Both stimuli display and assessment of the patient’s response are automatic and adapted to the characteristics of each child (age, development, and visual capabilities). These features, along with the portability of the device, allow us to bring the detection of visual problems to children of only a few months of age.