Early Screening Can Prevent Vision Abnormalities in Children

Vision screening has been recommended for all children between 3 and 5 years to detect amblyopia or its risk factors (a B recommendation) by the U.S. Preventive Services Task Force (USPSTF).

USPSTF concludes that the current evidence is //insufficient to assess the balance of benefits and harms of vision screening in children younger than 3 years (an I statement). Amblyopia is otherwise known as "lazy eye". The report appears in the issue of JAMA.

Amblyopia | Lazy Eye - Causes Symptoms Diagnosis Treatment FAQs Glossary
Amblyopia is the loss of one eye's ability to see details. Amblyopia is otherwise known as lazy eye.

‘Treating amblyopia or its risk factors early can aid in improving visual outcomes and other benefits in children.’

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A B recommendation indicates that there is high certainty that the net benefit is moderate, or there is moderate certainty that the net benefit is moderate to substantial. An I statement indicates that evidence is lacking, of poor quality, or conflicting, and the balance of benefits and harms cannot be determined.

One of the most important causes of vision abnormalities in children is amblyopia. 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.

Among children younger than 6 years, 1 percent to 6 percent have amblyopia or its risk factors. Early identification of vision abnormalities could prevent the development of amblyopia.

To update its 2011 recommendation, the USPSTF reviewed the evidence on the accuracy of vision screening tests and the benefits and harms of vision screening and treatment.

The USPSTF is an independent, volunteer panel of experts that makes recommendations about the effectiveness of specific preventive care services such as screenings, counseling services, and preventive medications.

Amblyopia Is The Key Factor For Slow Reading In School-Age Children
Children with amblyopic had about 35% more forward eye movements during reading than either strabismic children without amblyopia or normal children.

Detection

The USPSTF found adequate evidence that vision screening tools are accurate in detecting vision abnormalities, including refractive errors, strabismus (a misalignment of the eyes) and amblyopia, and found inadequate evidence to compare screening accuracy across age groups (younger than 3 vs 3 years and older). Many studies of clinical accuracy did not enroll children younger than 3 years.

Amblyopia or 'Lazy Eye' Could Change an Individuals' Brain Wiring
Using a brain scanning method called diffusion-weighted imaging, the research team mapped the pathways known to carry visual information from the eyes to the brain.

Benefits of Early Detection and Treatment

The USPSTF found adequate evidence that treatment of amblyopia or its risk factors in children ages 3 to 5 years leads to improved visual acuity and found inadequate evidence that treatment of amblyopia or its risk factors in children younger than 3 years leads to improved vision outcomes (i.e., visual acuity) or other benefits.

Harms of Early Detection and Treatment

The USPSTF found adequate evidence to assess harms of vision screening tests in children ages 3 to 5 years, including higher false-positive rates in low-prevalence populations. False-positive screening results may lead to overdiagnosis or unnecessary treatment.

The USPSTF found adequate evidence to bound the potential harms of vision screening and treatment in children ages 3 to 5 years as small, based on the nature of the interventions, and found inadequate evidence on the harms of treatment in children younger than 3 years.

Source-Eurekalert