Practical community photoscreening in very young children

Area of Science:

• Ophthalmology
• Pediatrics
• Preventive Medicine

Background:

• US Preventive Services Task Force found insufficient data for vision screening in children younger than 3 years.
• The Iowa KidSight program has screened children aged 6 months and older since 2000.
• This study evaluates vision screening in children younger than 3 years using photoscreening.

Purpose of the Study:

• To compare the effectiveness of photoscreening in children younger than 3 years with older children.
• To determine the reliability of photoscreening for detecting amblyogenic risk factors in very young children.
• To recommend an age for initiating photoscreening based on study findings.

Main Methods:

• Retrospective review of the Iowa KidSight database.
• Analysis of photoscreening results from May 2000 to April 2011.
• Comparison of screening outcomes between children <3 years and children aged 3-6 years.

Main Results:

• Over 210,000 photoscreens were analyzed.
• In children <3 years: unreadable rate 13.0%, referral rate 3.3%, positive-predictive value 86.6%.
• In children 3-6 years: unreadable rate 4.1%, referral rate 4.7%, positive-predictive value 89.4%.

Conclusions:

• No statistically significant difference in screening outcomes between children aged 1-3 years and older children.
• Photoscreening reliably detects amblyogenic risk factors in children younger than 3 years.
• Recommends initiating photoscreening in children aged 1 year and older.