The USPSTF found adequate evidence that treatment of amblyopia or its risk factors in children aged 3 to 5 years leads to improved visual acuity. Benefits of Early Detection and Treatment Many studies of clinical accuracy did not enroll children younger than 3 years. The USPSTF found inadequate evidence to compare screening accuracy across age groups (<3 vs ≥3 years). The USPSTF found adequate evidence that vision screening tools are accurate in detecting vision abnormalities, including refractive errors, strabismus, and amblyopia. 1, 3-7 Early identification of vision abnormalities could prevent the development of amblyopia. 1 Among children younger than 6 years, 1% to 6% have amblyopia or its risk factors (strabismus, anisometropia, or both), which, if left untreated, could lead to amblyopia. Other common causes of vision abnormalities are nonamblyopic strabismus and nonamblyopic refractive error. Risk factors associated with the development of amblyopia include strabismus (ocular misalignment) vision deprivation caused by media opacity (eg, cataracts) high, uncorrected refractive errors (eg, myopia, hyperopia, and astigmatism) and anisometropia ( Table 1). 1, 2 It usually occurs in 1 eye but can occur in both. Amblyopia is an alteration in the visual neural pathway in a child’s developing brain that can lead to permanent vision loss in the affected eye. One of the most important causes of vision abnormalities in children is amblyopia (also known as “lazy eye”). The USPSTF concludes that the benefits of vision screening to detect amblyopia or its risk factors in children younger than 3 y are uncertain, and that the balance of benefits and harms cannot be determined.įor a summary of the evidence systematically reviewed in making this recommendation, the full recommendation statement, and supporting documents, please go to. The USPSTF concludes with moderate certainty that vision screening to detect amblyopia or its risk factors in children aged 3 to 5 y has a moderate net benefit. Primary treatment includes correction of any underlying refractive error with the use of corrective lenses, occlusion therapy for amblyopia (eye patching, atropine eye drops, or Bangerter occlusion foils), or a combination of treatments. Various screening tests are used in primary care to identify vision abnormalities in children, including: the red reflex test, the cover-uncover test, the corneal light reflex test, visual acuity tests (such as Snellen, Lea Symbols, and HOTV charts), autorefractors and photoscreeners, and stereoacuity tests. Additional risk factors associated with amblyopia, strabismus, or refractive errors include family history in a first-degree relative, prematurity, low birth weight, maternal substance abuse, maternal smoking during pregnancy, and low levels of parental education. Screen at least once to detect amblyopia or its risk factors.Īll children aged 3 to 5 years are at risk of vision abnormalities and should be screened specific risk factors include strabismus, refractive errors, and media opacity.
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