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Clinical Summary

Vision in Children Ages 6 Months to 5 Years: Screening

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.

Population Children aged 3 to 5 y Children younger than 3 y

Screen at least once to detect amblyopia or its risk factors.
Grade: B

No recommendation.
Grade: I (insufficient evidence)
Risk Assessment All 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. 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.
Screening Tests 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.
Treatments 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.
Balance of Benefits and Harms 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. 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.


Current as of: September 2017

Internet Citation: Clinical Summary: Vision in Children Ages 6 Months to 5 Years: Screening. U.S. Preventive Services Task Force. September 2017.

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