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Children
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Visual Deficits and Eye Care in Children
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Visual Deficits and Eye Care in Children

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Ophthalmology".

Deadline for manuscript submissions: 1 September 2025 | Viewed by 6412

Special Issue Editors

Dr. Tsz Wing Leung

E-Mail Website
Guest Editor
School of Optometry, The Hong Kong Polytechnic University, Hong Kong
Interests: astigmatism; vision defeats; amblyopia; children
Prof. Dr. Henry HL Chan

E-Mail Website
Guest Editor
Laboratory of Experimental Optometry (Neuroscience), School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
Interests: visual electrophysiology; myopia; retinal physiology; children

Special Issue Information

Dear Colleagues,

The importance of vision in children’s personal development is indisputable. As a key sensory input, vision is pivotal in various aspects of a child’s life, including learning, social networking, sports, and other activities. Healthy vision is not merely about clear sight; it is a fundamental building block for a child’s overall growth and development.

Despite the crucial role of vision, not all children are fortunate to have good eyesight. Visual deficits in childhood can stem from a myriad of problems, ranging from refractive errors, strabismus, and amblyopia to various congenital or developmental disorders. If left undetected or untreated, these deficits can significantly impede a child’s development.

Considering this, this Special Issue aims to gather and present information about visual deficits in children, from their causes and impacts to the methods of detection and treatment. Our goal is to foster a deeper understanding of these issues and promote effective eye care strategies that can ensure children’s visual health.

In this pursuit, we welcome original research articles, including epidemiological, observational, and experimental studies, clinical trials, and basic research. We also invite systematic or narrative reviews and meta-analyses. We look forward to your valuable contributions to this Special Issue and advancing our understanding of this critical topic.

Dr. Tsz Wing Leung
Prof. Dr. Henry HL Chan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • visual deficits
  • pediatric eye care
  • childhood vision problems
  • refractive errors
  • strabismus
  • amblyopia
  • congenital visual disorders
  • developmental disorders
  • eye health policies

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

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11 pages, 411 KiB  
Article
Comparison of Virtual Reality-Assisted Visual Training with Conventional Strategies in the Treatment of Bilateral Refractive Amblyopia
by Hsiu-Mei Huang, Yu-Ting Hsiao, Yi-Hao Chen and I-Hui Yang
Children 2025, 12(4), 447; https://doi.org/10.3390/children12040447 - 31 Mar 2025
Viewed by 392
Abstract
Background: Visual training based on perceptual learning and dichoptic stimulation has been developed for amblyopic treatment. However, reports on virtual reality-assisted (VR) training for amblyopia are limited. The aim of this study was to evaluate the effects of VR training and compare the [...] Read more.
Background: Visual training based on perceptual learning and dichoptic stimulation has been developed for amblyopic treatment. However, reports on virtual reality-assisted (VR) training for amblyopia are limited. The aim of this study was to evaluate the effects of VR training and compare the visual outcomes of different treatments in children with bilateral refractive amblyopia. Methods: Children aged 4–8 years with a best-corrected visual acuity (BCVA) less than 20/25 were included. All of the patients had worn glasses for at least 2 months before enrollment. At enrollment, age, gender, refractive status, baseline BCVA, and amblyopia severity were recorded. The treatment outcomes were evaluated in terms of BCVA at 24 weeks, the change in BCVA from baseline to 24 weeks, and the time taken to achieve treatment success (BCVA ≥ 20/25). Results: The longitudinal study included 30 patients in the Cambridge Visual Stimulator (CAM) training group, 14 in the VR training group, and 26 in the control group (glasses only). Among patients with an initial BCVA between 20/100 and 20/40, a significantly higher proportion of those in the VR training group achieved treatment success compared to the control group (p = 0.022). Among those who achieved treatment success, the time taken to achieve success was significantly shorter in the CAM and VR training groups compared to the control group (p < 0.001). Conclusions: Visual training can shorten the time taken to achieve treatment success compared to glasses alone. While VR training seems more effective than CAM training, both are valuable strategies for amblyopic children who respond poorly to glasses alone. Full article
(This article belongs to the Special Issue Visual Deficits and Eye Care in Children)
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10 pages, 1170 KiB  
Article
Evaluation of Meibography Findings and Ocular Surface Parameters in Children with Atopic Dermatitis Without Eye Complaints
by Şenol Sabancı, Hediye Küçükkeleş, Fatih Çelmeli and Sibel Yavuz
Children 2025, 12(2), 150; https://doi.org/10.3390/children12020150 - 27 Jan 2025
Viewed by 742
Abstract
Background/Objectives: To evaluate the meibomian gland (MG) morphology and ocular surface parameters of children with atopic dermatitis (AD) without ocular symptoms. Materials and Method: Forty-five eyes of 24 children with AD and 44 eyes of 27 healthy children were included in the study. [...] Read more.
Background/Objectives: To evaluate the meibomian gland (MG) morphology and ocular surface parameters of children with atopic dermatitis (AD) without ocular symptoms. Materials and Method: Forty-five eyes of 24 children with AD and 44 eyes of 27 healthy children were included in the study. Upper and lower eyelid meibography measurements were performed for all cases and the rate of MG loss and the amount of tortuosity were evaluated. A Schirmer 1 test, tear break-up time (TBUT) test, and corneal staining scoring (CSS) were applied to all cases. Results: MG loss in the upper eyelid was 15.51 ± 10.39% in the AD group, while it was 9.30 ± 5.30% in the control group (p = 0.002). MG loss in the lower eyelid was 15.79 ± 10.93% in the AD group, while it was 9.23 ± 6.90% in the control group (p = 0.002). The rate of tortuosity in 26–50% of the upper and lower eyelid MGs was significantly higher in the AD group than in the healthy control group (p = 0.002 and p = 0.007, respectively). The Schirmer 1 test values were 10.98 ± 3.89 in the AD group and 17.41 ± 3.73 in the healthy control group (p < 0.0001). The TBUT values were found to be 9.18 ± 1.99 in the AD group and 11.40 ± 1.82 in the healthy control group (p < 0.0001). The CSS result was found to be significantly higher in the AD group than in the control group (p = 0.001). Conclusions: Significant MG loss was detected in patients with AD without eye complaints, which may cause the early deterioration of ocular surface parameters. We believe that close follow-up examinations of children with AD in terms of ocular surface complications may be necessary. Full article
(This article belongs to the Special Issue Visual Deficits and Eye Care in Children)
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11 pages, 2428 KiB  
Article
Developing a Novel Pediatric Eye Chart Assessing Visual Acuity by Minimum Separable Threshold
by Yo Iwata
Children 2024, 11(4), 397; https://doi.org/10.3390/children11040397 - 27 Mar 2024
Cited by 1 | Viewed by 2510
Abstract
The purpose of this study was to develop a new pediatric acuity chart that can assess the minimum separation threshold by incorporating the minimum separation threshold into the picture. To overcome the design limitations of the Landolt ring, two designs of highly versatile [...] Read more.
The purpose of this study was to develop a new pediatric acuity chart that can assess the minimum separation threshold by incorporating the minimum separation threshold into the picture. To overcome the design limitations of the Landolt ring, two designs of highly versatile minimum separable thresholds that can be easily incorporated into a picture were created: a black, filled circle (the “Circle”) and a segment (the “Square”), both with the same break as in the Landolt ring. The three designs—the Landolt ring, Circle, and Square—were used to evaluate and compare the differences in the visual acuity of 21 healthy adults. No significant differences were observed between the results of the visual acuity tested with the Landolt ring, Circle, and Square (Landolt ring vs. Circle: p = 0.92, Landolt ring vs. Square: p = 0.31, Circle vs. Square: p = 0.40). The Bland–Altman analysis revealed no fixed errors between the Landolt ring and Circle and between the Landolt ring and Square (95% CI: −0.09–0.08, −0.09–0.12). Proportional errors were also not observed (p = 0.68, p = 0.41). The Landolt ring, Circle, and Square designs obtained equal results in visual acuity, thus achieving the successful development of a novel pediatric visual acuity chart using these designs. Full article
(This article belongs to the Special Issue Visual Deficits and Eye Care in Children)
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Review

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13 pages, 677 KiB  
Review
Media Device Use and Vision Disorders in the Pediatric Age: The State of the Art
by Elena Bozzola, Mariangela Irrera, Romie Hellmann, Salvatore Crugliano and Michele Fortunato
Children 2024, 11(11), 1408; https://doi.org/10.3390/children11111408 - 20 Nov 2024
Viewed by 1629
Abstract
Introduction. Evidence is consistent with increased screen viewing time among children and adolescents, and anticipation at the age at which children interact with media devices. Incorrect use of technology, as well as overuse, may lead to serious consequences. This study aims to revise [...] Read more.
Introduction. Evidence is consistent with increased screen viewing time among children and adolescents, and anticipation at the age at which children interact with media devices. Incorrect use of technology, as well as overuse, may lead to serious consequences. This study aims to revise scientific international literature and to describe the potential eye risks correlated to screen viewing time in the pediatric age. Materials and Methods. A review of the literature was performed according to the PRISMA 2020 guidelines, using the search terms “media device” and “eye” with the filter “age 0–18”. Results. Analyzing the international literature, we found 26 articles. Pre-myopia, myopia, digital eye strain, and acute acquired comitant esotropia were listed as potential and time-related consequences associated with the incorrect use of media devices among children and adolescents. Discussion. Family education on media device exposure and potential risk for children and adolescents’ sight in case of prolonged digital/screen exposure is required. During pediatric check controls, a dialogue with families on prolonged media device use at a close distance should be undertaken. Pediatricians and ophthalmologists should consider screen viewing time in case of ocular problems. Full article
(This article belongs to the Special Issue Visual Deficits and Eye Care in Children)
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Other

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9 pages, 1630 KiB  
Case Report
Giant Cyst of Dermis-Fat Graft in a Child with MRSA—Case Report
by Biljana Kuzmanović Elabjer, Mirjana Bjeloš, Ana Ćurić, Daliborka Miletić and Mladen Bušić
Children 2025, 12(4), 457; https://doi.org/10.3390/children12040457 - 2 Apr 2025
Viewed by 256
Abstract
Background/Objectives: This case report presents a unique case of multiple postoperative complications, including sterile silicone implant extrusion, symblepharon formation, and the development of a giant cyst, following extensive multimodal chemotherapy for unilateral retinoblastoma in a pediatric patient. The case was further complicated by [...] Read more.
Background/Objectives: This case report presents a unique case of multiple postoperative complications, including sterile silicone implant extrusion, symblepharon formation, and the development of a giant cyst, following extensive multimodal chemotherapy for unilateral retinoblastoma in a pediatric patient. The case was further complicated by recurrent methicillin-resistant Staphylococcus aureus (MRSA) colonization, which persisted despite multiple eradication attempts. Methods: A 5-year-old boy presented with right-sided proptosis one year after receiving a secondary dermis-fat orbital graft. He had undergone 12 cycles of intravitreal, intra-arterial, and systemic chemotherapy as well as thermotherapy and cryotherapy due to recurrent retinoblastoma in the right eye. Following a third relapse, secondary enucleation was performed with a primary silicone orbital implant. However, extrusion of the implant occurred, and an orbital swab confirmed MRSA colonization. A secondary dermis-fat graft was harvested and implanted after ensuring MRSA clearance. A year later, the child developed rapid right-sided proptosis. Ultrasound revealed a cyst within the dermis-fat graft measured 23.6 mm in anteroposterior diameter. Surgery was postponed due to chickenpox, and the cyst enlarged reaching an anteroposterior diameter of 26.7 mm over two months. A complete excision was performed. Results: The surgery was uneventful. Intraoperative orbital swab was sterile, but MRSA was detected in a conjunctival swab, leading to treatment with local moxifloxacin drops and oral rifampicin. Conclusions: Giant cyst formation in a dermis-fat graft is an extremely rare complication. Complete excision remains the treatment of choice. However, in this case, it resulted in persistent anophthalmic socket syndrome, posing further reconstructive challenges. Full article
(This article belongs to the Special Issue Visual Deficits and Eye Care in Children)
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