CLINICAL SUMMARY OF U.S. PREVENTIVE SERVICES TASK FORCE RECOMMENDATION

PopulationChildren ages 3 to 5 yearsChildren younger than 3 years of age
RecommendationProvide vision screening.
Grade: B		No recommendation.
Grade: I (Insufficient Evidence)
Screening TestsVarious screening tests are used in primary care to identify visual impairment in children, including:
  • Visual acuity test
  • Stereoacuity test
  • Cover-uncover test
  • Hirschberg light reflex test
  • Autorefraction
  • Photoscreening
Timing of ScreeningNo evidence was found regarding appropriate screening intervals.
InterventionsPrimary treatment for amblyopia includes the use of corrective lenses, patching, or atropine therapy of the non-affected eye. Treatment may also consist of a combination of interventions.
Balance of Benefits and HarmsThere is adequate evidence that early treatment of amblyopia in children ages 3 to 5 years leads to improved visual outcomes. There is limited evidence on harms of screening, including psychosocial effects, in children ages 3 years and older.
There is inadequate evidence that early treatment of amblyopia in children younger than 3 years of age leads to improved visual outcomes.
Suggestions for Practice Regarding the I StatementIn deciding whether to refer children younger than 3 years of age for screening, clinicians should consider:
  • Potential preventable burden: screening later in the preschool years seems to be as effective as screening earlier
  • Costs: initial high costs associated with autorefractors and photoscreeners
  • Current practice: typical vision screening includes assessment of visual acuity, strabismus, and stereoacuity; children with positive findings should be referred for a comprehensive ophthalmologist exam

From: Recommendations for Children and Adolescents

Cover of The Guide to Clinical Preventive Services 2012
The Guide to Clinical Preventive Services 2012: Recommendations of the U.S. Preventive Services Task Force.
Copyright Notice

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.