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USPSTF recommends screening for lazy eye in children aged 3 to 5 years
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The U.S. Preventive Services Task Force recommends that clinicians screen children for amblyopia or its risk factors at least once while the child is between 3 and 5 years of age, according to a report just released from JAMA.
Among children younger than 6 years, 1% to 6% have amblyopia or its risk factors, which include anisometropia, strabismus, or both, according to researchers.
“Untreated amblyopia rarely resolves spontaneously,” Daniel E. Jonas, MD, MPH, associate professor in the department of medicine at the University of North Carolina Chapel Hill, and colleagues wrote. “Left untreated, vision abnormalities in young children could lead to problems at school, bullying, reduced function and quality of life, depression and anxiety, and injuries. Vision abnormalities are often treatable, but efficacy can decrease as children age, and visual loss can become irreversible.”
The task force also said its recommendation cannot currently be extended to younger children.
“We found that there is not enough evidence to determine if screening children younger than age 3 is beneficial,” David C. Grossman, MD, MPH, pediatrician at Kaiser Permanente Washington, senior medical director for the Washington Permanente Medical Group, and task force chair, said in a press release. “The Task Force is calling for more research to better understand the balance of benefits and harms of screening in this age group.”
USPSTF members also said that these recommendations uphold their previous 2011 statements on amblyopia and its risk factors, and that these statements mirror the AAFP’s stance on screening for amblyopia or its risk factors in children younger than 5 years old.
A task force member told Healio Family Medicine it’s important for primary care physicians and parents to have two-way discussions about vision screening.
“Parents should understand that vision screening for children ages 3 to 5 is important to detect amblyopia, sometimes called lazy eye, or conditions that if untreated could lead to amblyopia. There is insufficient scientific evidence to recommend for or against vision screening for younger children,” Alex R. Kemper MD, MPH, MS, division chief, ambulatory pediatrics at Nationwide Children’s Hospital in Ohio. “Primary care providers should listen to concerns that parents might have about their children’s vision when determining whether to offer vision screening,” said in an interview. – by Janel Miller
Disclosure: The researchers report no relevant financial disclosures.