Usually, most children do not need a complete eye examination; however, all children should have serial screenings. Objective, device-based vision screening or photoscreening is an excellent way to accomplish screening in young children. With the right referral criteria in place, screenings in preschoolers can help to identify risk factors for amblyopia. Therefore, children’s screening should be performed yearly.
Recently the American Association for Pediatric Ophthalmology and Strabismus added the option of photoscreening for children ages 12 months to 36 months to its recommendations. If a child fails the screening, it is then referred to an eye care provider for a complete eye examination with dilation.1 Not all children who have a refractive error will need to wear glasses; the treatment will depend on their individual situation and factors such as age and the level of risk for developing amblyopia.
Therefore, it is crucial that there is a follow through when a child is referred with a “Refer” screening result for a complete exam. Communication is key throughout this process, starting with the person who performs the vision screening.
In January 2016, the American Academy of Pediatrics updated its vision screening policy for pediatricians. The policy statement recommends that instrument-based screening in the office setting be first attempted between 12 months and 3 years of age and at annual well-child visits thereafter until acuity can be tested directly.
Read how the updated vision screening statement spurs change in a pediatrician’s practice in our today’s blogpost by Denise Brown, MD.
Photoscreening is an efficient and effective method of identifying kids at risk for amblyopia.
The Kodiak Area Native Association (KANA) serves a 12,000-member community located on a large, mostly uninhabited island in Alaska. I am a Developmental Specialist with the KANA Infant Learning Program. This is a part of the Alaska Early Intervention system that works with young children, who are experiencing developmental delays, or are at risk of developing such delays, and their families.
KANA collaborates with Alaska Blind Child Discovery (ABCD), a cooperative, charitable research project to conduct vision screening on every preschooler in Alaska. ABCD is the brain child of pediatric ophthalmologist Robert Arnold, MD. During his pediatric fellowship at Indiana University, Dr. Arnold became intrigued with detecting small-angle strabismus using the Brückner Test. After starting practice in Anchorage with Ophthalmic Associates in 1989, he began publishing clinical research around modifying the test. As his interest in photoscreening advanced, Dr. Arnold began working with public health nurses, and later various charities to launch screening clinics in urban and remote villages.