Red reflex: preventing childhood blindness

Resumo

Introduction: Children are a priority for the "Vision 2020" initiative in the prevention of avoidable blindness, requiring a comprehensive performance from primary care through the red reflex test (RRT), essential in detecting visual abnormalities. The American Academy of Pediatrics (AAP) recommends testing in neonatal ocular assessment and all subsequent queries of the child.

Objective: Promote the implementation of the red reflex test in Residency Training in Family Medicine of the Federal University of Rio Grande do Norte (UFRN) and clarify the importance of its incorporation by Family Physicians.

Methodology or experience description: RRT should preferably be performed under dim light at a distance of approximately 30 cm of the child, trying to see the red and symmetrical reflection through the pupillary opening of both eyes with an ophthalmoscope. Any change in red reflex as dark spots, absence or asymmetry of reflex, or presence of white reflex (leukocoria) are reasons for suspecting eye diseases, the child should be referred for specialist examination by an ophthalmologist.

Results: The test has been routinely performed in the unit where the postgraduating training in Familiy Medicine – UFRN/ Onofre Lopes Hospital works and meets huge demand, including other municipalities. The test, beyond the screening of ocular diseases allows the encouragement of breastfeeding, guidelines for the prevention of accidents, capture patients for mother-craft and update vaccination status. It also provides opportunities to medical students during the internship in Family Medicine, learn the technique and importance of testing. The aim is also become a partner with Ophthalmology Department to assess the altered tests.

Conclusions or Hypothesis: Considering the importance of the Family Medicine in health systems, we conclude the need of RRT implantation at maternity hospitals and in clinical practice with 1, 2, 4, 6 and 9 months, 1, 2, 3, 4, 5, 6, 8, 10 and 12 years old, as recommended by the AAP. We know the difficulties of incorporating the test, but it is a relevant action in promoting eye health and prevention of blindness in childhood.