Pediatric Vision Screening

Allison R. Loh; Michael F. Chiang

doi:10.1542/pir.2016-0191

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Allison R. Loh, MD*
Michael F. Chiang, MD*,^†

^*Department of Ophthalmology and
^†Department of Medical Informatics and Clinical Epidemiology, Casey Eye Institute, Oregon Health and Science University, Portland, OR

AUTHOR DISCLOSURE
Dr Loh has disclosed no financial relationships relevant to this article. Dr Chiang has disclosed that he has received research grants from the National Institutes of Health and the National Science Foundation, that he is an unpaid member of the Scientific Advisory Board of Clarity Medical Systems, and that he is a consultant/steering committee member of the RAINBOW study for Novartis. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

Practice Gap

Incorporating vision screening and a basic eye examination in the primary care setting can be challenging. Determining which screening examination to perform and when to refer a patient to a pediatric eye care provider is critical.

Objectives

After completing this article, readers should be able to:

Understand the importance of vision screening and know what conditions can be detected by periodic eye examinations.
Describe the components of a vision screening examination at different ages and plan an appropriate evaluation of vision.
Recognize the indications for referral to pediatric ophthalmology.

Introduction

Vision screening is crucial for early detection and prevention of vision loss in young children. Vision screening can be performed by primary care providers, trained laypersons (eg, school-based screenings), and eye care providers. Vision screening techniques are either provider-based (eg, traditional acuity testing, inspection, red reflex testing) or instrument-based. Instrument-based screening can often be performed at an earlier age than provider-based acuity testing and allows earlier screening for risk factors that are likely to lead to amblyopia and poor vision. The American Academy of Pediatrics (AAP) and the American Association for Pediatric Ophthalmology and Strabismus have developed guidelines to help practitioners screen for vision problems at different ages (Table 1).

View this table: