Guidelines for automated preschool vision screening

A 10-year, evidence-based update

Sean P. Donahue, Brian Arthur, Daniel Neely, Robert W. Arnold, David Silbert, James B. Ruben

Research output: Contribution to journalArticle

99 Citations (Scopus)

Abstract

In 2003 the American Association for Pediatric Ophthalmology and Strabismus Vision Screening Committee proposed criteria for automated preschool vision screening. Recent literature from epidemiologic and natural history studies, randomized controlled trials of amblyopia treatment, and field studies of screening technologies have been reviewed for the purpose of updating these criteria. The prevalence of amblyopia risk factors (ARF) is greater than previously suspected; many young children with low-magnitude ARFs do not develop amblyopia, and those who do often respond to spectacles alone. High-magnitude ARFs increase the likelihood of amblyopia. Although depth increases with age, amblyopia remains treatable until 60 months, with decline in treatment effectiveness after age 5. US Preventive Services Task Force Preventative Services Task Force guidelines allow photoscreening for children older than 36 months of age. Some technologies directly detect amblyopia rather than ARFs. Age-based criteria for ARF detection using photoscreening is prudent: referral criteria for such instruments should produce high specificity for ARF detection in young children and high sensitivity to detect amblyopia in older children. Refractive screening for ARFs for children aged 12-30 months should detect astigmatism >2.0 D, hyperopia >4.5 D, and anisometropia >2.5 D; for children aged 31-48 months, astigmatism >2.0 D, hyperopia > 4.0 D, and anisometropia >2.0 D. For children >49 months of age original criteria should be used: astigmatism >1.5 D, anisometropia>1.5 D, and hyperopia >3.5 D. Visually significant media opacities and manifest (not intermittent) strabismus should be detected at all ages. Instruments that detect amblyopia should report results using amblyopia presence as the gold standard. These new American Association for Pediatric Ophthalmology and Strabismus Vision Screening Committee guidelines will improve reporting of results and comparison of technologies.

Original languageEnglish
Pages (from-to)4-8
Number of pages5
JournalJournal of AAPOS
Volume17
Issue number1
DOIs
StatePublished - Feb 2013

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Vision Screening
Amblyopia
antineoplaston A10
Guidelines
Anisometropia
Hyperopia
Astigmatism
Advisory Committees
Technology
Strabismus
Natural History

ASJC Scopus subject areas

  • Ophthalmology
  • Pediatrics, Perinatology, and Child Health

Cite this

Guidelines for automated preschool vision screening : A 10-year, evidence-based update. / Donahue, Sean P.; Arthur, Brian; Neely, Daniel; Arnold, Robert W.; Silbert, David; Ruben, James B.

In: Journal of AAPOS, Vol. 17, No. 1, 02.2013, p. 4-8.

Research output: Contribution to journalArticle

Donahue, Sean P. ; Arthur, Brian ; Neely, Daniel ; Arnold, Robert W. ; Silbert, David ; Ruben, James B. / Guidelines for automated preschool vision screening : A 10-year, evidence-based update. In: Journal of AAPOS. 2013 ; Vol. 17, No. 1. pp. 4-8.
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