It wasn’t until Isis started school that her mum realised she had a problem with her eyes. Standing at the school gates, her mother Marsha would watch her little four year old run up to other mums in the playground and give them a huge hug. It was only when she called that young Isis realised she’d accidentally embraced someone else’s parent.
“It’s huge,” says Marsha. “It stopped Isis making friends and playing games. Of course everyone looks the same in school uniforms to her, so I had to get to know all her friends so I could point out where different groups were and what they were playing. It saddens me. You can see she’s missing out. Sometimes she says, ‘By the time I find my friends to play with, the bell goes’.”
Isis was one of the million children that the Eyecare Trust expects to go back to school each year with undiagnosed eye conditions. Failing to get a diagnosis can lead to more than discomfort. Isis started suffering academically at school as she found reading almost impossible, others can become withdrawn and badly behaved as they are frustrated, and confidence can be damaged. Most importantly, failure to diagnose a child early can mean doctors lose the window of opportunity to treat the child.
“If it’s a squint or a lazy eye, we can usually treat it and fix it if the child is under eight,” says Dr Sarah Farrant, a council member of the College of Optometrists, who has her own practice in Somerset. “It’s really key to catch this early so more can be done because, over the age of eight to ten, it’s hard to do anything as the condition becomes established.”
In extreme cases, early diagnosis can make the difference between life and death. Ceri Kitty first thought she should get her daughter’s eye test done when she heard other parents talking about it near her home in Swindon. Her daughter Ellie wasn’t showing any symptoms, so Kitty expected everything to be fine. But when she took her into the opticians, her world was turned upside down.
“The opticians said she needed to go to hospital, that same day. It was like being hit by a sledgehammer. There were no real details given; she just had to go straight to hospital. My mind went into overdrive. There were more tests and then we were told she had retinoblastoma and I didn’t have a clue what that was. They told us it was a tumour in her optic nerve. She couldn’t see out of her left eye.”
Failure to diagnose a child early can mean doctors lose the window of opportunity to treat the child
Ellie was diagnosed just before her fifth birthday. The family still doesn’t know how long the tumour had been there. Because one eye was functioning perfectly, Ellie had never given away any major signs of having a problem that needed to be checked. But within a week of having an eye test, Ellie’s left eye was removed. If they hadn’t detected her condition, it could have been fatal.
“I can’t stress how important eye tests are,” says Kitty. “They can be life-saving. I wish I’d taken Ellie earlier. I’d thought, ‘How can they tell if she has a problem when she’s so young – she won’t even be able to read the letters on the chart.’ But, of course, they can tell. If they’d have got there sooner, there is chance that she could have tried other treatments and kept her left eye. I’m not stupid by any stretch of the imagination, but I’d never heard of these conditions. Thankfully they’re rare, but there’s not enough awareness.”
Despite these devastating cases, research from the College of Optometrists shows that about one in ten parents (9 per cent) can’t remember the last time their child was tested, or believe it has been more than ten years since their last test. The report, published in February, also found that 25 per cent of parents admitted that their child had never had a sight test – a significant increase on the 2011 figure of 14 per cent. According to Dr Farrant, most of this comes down to parental awareness, or lack of it.
“Fundamentally it all depends on how vigilant the parents are,” she says. “It really depends on public education. Adults assume that, if children have an eye problem, they’ll tell them or it will be picked up at school. Years ago there used to be eye tests in school, but now they just get screened. That’s nowhere near as thorough as a full eye test at an opticians. Children really need a full eye test every year.”
It’s not always easy to tell if a child does have a problem. Children are excellent at adapting, they can move closer to the board, if they can’t see at school, or pull books closer to their faces, so it’s hard to tell when they’re struggling. If the child already has a learning disability, then the problems with reading can be mistaken as part of that disability.
Similarly, children who come from families where parents are less attentive are more likely to go undiagnosed for longer, and poorer families might not realise that children’s eye tests are free and be put off by perceived cost. Talking to Marsha, she just hopes more parents will read her story about Isis and get their children tested earlier.
“I do believe I should have gone to get Isis tested at an earlier age,” she says. “I believe it didn’t make a difference in the end, but sometimes it’s possible to manipulate the eye to make it better when they’re young. But the window to do that is quite small. I didn’t know that before. I really hope other parents will learn from our experiences and get their child tested earlier.”
