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[Vision screening for children: Recommended practices from AFSOP]
L Lequeux1, D Thouvenin1, C Couret2
1Ophtalmologie Rive-Gauche, clinique Rive-Gauche, 47, allées Charles-de-Fitte, 31300 Toulouse, France.
Insights
Updated guidelines recommend early ophthalmologic exams for high-risk infants and toddlers to detect amblyopia. Children without risk factors should undergo systematic visual screening in their third year.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Vision Science
Background:
- Amblyopia, or "lazy eye," is a leading cause of preventable vision impairment in children.
- Early detection and intervention are crucial for successful treatment outcomes.
- Existing screening protocols require updates based on current evidence.
Purpose of the Study:
- To provide updated, evidence-based recommendations for visual screening in children.
- To define age-specific screening strategies for different risk groups.
- To establish clear referral criteria for pediatric ophthalmologic examination.
Main Methods:
- A workgroup of experts convened to review international literature and formulate guidelines.
- Recommendations include ophthalmologic examinations for at-risk infants and toddlers.
- Systematic orthoptic screening is advised for children without risk factors.
Main Results:
- Ophthalmologic exams are recommended within the first month for infantile organic amblyopia risk.
- Cycloplegic refraction is advised between 12-15 months for functional amblyopia risk.
- Screening at age three includes visual acuity, cover test, and photoscreening with specific referral criteria.
Conclusions:
- Updated guidelines provide a structured approach to pediatric visual screening.
- Timely and appropriate screening can prevent vision loss from amblyopia.
- Clear referral criteria ensure efficient use of ophthalmologist resources.
Abstract:
In light of the international literature, a workgroup of experts from the AFSOP met in February 2019 to formulate updated recommendations for visual screening in children. An ophthalmologic examination during the first month of life is recommended for children at risk of developing infantile organic amblyopia. An ophthalmologic examination including cycloplegic refraction between 12 and 15 months of age is recommended for children at risk of developing functional amblyopia. At any age, a prompt ophthalmologic examination is recommended for a child suspected of functional or organic ocular pathology. In children without risk factors or warning signs, a systematic orthoptic screening examination is recommended during the third year of life, including a monocular visual acuity test, a cover-test and a refraction by photoscreener. The child is referred to the ophthalmologist only in the case of an abnormal screening result, according to the following criteria: visual acuity <5/10, or >1 difference between eyes, abnormal cover test, photodetection refraction values <-3D or>+2.5D for the sphere,>1.5D for astigmatism and>1D for anisometropia. Finally, we review normal childhood refractive errors as a function of age as well as the correct use of photo screening devices.
