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U.S. Preventive Services Task Force


Screening for Visual Impairment in Children Ages 1 to 5

Clinical Summary of U.S. Preventive Services Task Force Recommendation

This document is a summary of the 2011 recommendation of the U.S. Preventive Services Task Force on Screening for Visual Impairment in Children Ages 1 to 5. It is intended for use by primary care clinicians. This summary was first published in Pediatrics (Pediatrics 2011;127:341).

Population Children ages 3 to 5 years Children younger than 3 years of age
Recommendation Provide vision screening No recommendation

Grade: B

Grade: I
(Insufficient Evidence)
Screening Tests Various 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 Screening No evidence was found regarding appropriate screening intervals.
Interventions Primary 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 Harms and Benefits There 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 Statement In 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

For a summary of the evidence systematically reviewed in making these recommendations, the full recommendation statement, and supporting documents, please go to http://www.uspreventiveservicestaskforce.org.

Disclaimer: Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

AHRQ Publication No. 11-05151-EF-3
Current as of January 2011

Internet Citation:

U.S. Preventive Services Task Force. Screening for Visual Impairment in Children Ages 1 to 5: Clinical Summary of U.S. Preventive Services Task Force Recommendation. AHRQ Publication No. 11-05151-EF-3, January 2011. http://www.uspreventiveservicestaskforce.org/uspstf11/vischildren/vischildsum.htm

 


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