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Vision screening of preschool children: evaluating the past, looking toward the future
E B Ciner1, P P Schmidt, D Orel-Bixler
1Pennsylvania College of Optometry, Philadelphia, USA.
Insights
Early detection of preschool vision problems is crucial, yet few children receive eye exams. Vision screening aims to identify issues cost-effectively, but effective methods and implementation remain a challenge.
Area of Science:
- Ophthalmology
- Public Health
- Pediatrics
Background:
- Vision problems in preschool children are common but often undetected.
- Comprehensive eye exams are effective but received by only 14% of children under six.
- Vision screening is recommended as a cost-effective alternative for early detection.
Purpose of the Study:
- To summarize current laws and guidelines for preschool vision screening in the U.S.
- To review the advantages and disadvantages of various vision screening test procedures.
- To provide recommendations for developing effective future preschool vision screening programs.
Main Methods:
- Review of existing U.S. state laws and organizational guidelines for preschool vision screening.
- Analysis of the pros and cons of different vision screening tests suitable for preschool-aged children.
- Synthesis of information to inform recommendations for program development.
Main Results:
- Despite recommendations, only 21% of preschool children are actually screened for vision problems.
- There is a lack of consensus on the most effective screening methods.
- Many newer screening tests lack validation, despite state or organizational recommendations.
Conclusions:
- Current preschool vision screening practices in the U.S. face challenges in implementation and effectiveness.
- There is a need for validated, highly effective screening models and clearer guidelines.
- Future programs should focus on evidence-based methods and improved accessibility for preschool vision care.
Abstract:
Vision problems of preschool children are detectable with a comprehensive eye examination; however, it is estimated that only 14% of children below the age of 6 years receive an eye examination. Screening is advocated as a cost-effective alternative to identify children in need of further vision care. Thirty-four states recommend or require vision screening of preschool children. Although laws and guidelines exist, only 21% of preschool children are actually screened for vision problems. There is little agreement concerning the best screening methods, and no validated, highly effective model for screening vision of preschool children. Newer screening tests have been designed specifically for preschool populations, and can be administered by lay screeners. Many have not been validated. Several are recommended by states or organizations without convincing scientific evidence of their effectiveness. This paper summarizes current laws and guidelines for preschool vision screening in the United States, reviews advantages and disadvantages of several test procedures, and provides recommendations for developing future preschool vision screening programs.