Vision Screening Outcomes in Children Less Than 3 Years of Age Compared to Children Older than 3 Years of Age
Heather A. Stiff, MD; Scott Larson, MD; Nicholas B. Dimenstein, BS
The University of Iowa Department of Ophthalmology and Visual Sciences
Iowa City, IA
Introduction: The USPSTF states that vision screening is recommended for children ages 3-5, but that current evidence is insufficient to assess the benefits and harms in those younger than age 3. This study aims to compare vision screening outcomes between children in these age groups from a well-established photoscreening program.
Methods: This was a retrospective chart review of children over a 13-year period who failed vision photoscreening by Iowa KidSight and were subsequently seen at the University of Iowa.
Results: Of 304 subjects, 22% were 0-2 years and 78% were 3 years or older at the time of screening. Amblyopia rates were statistically similar in the two groups with 34% in the younger group and 45% in the older group (p=0.13). Normal vision was attained on average at 40.2 months of age in the younger group and 62.2 months in the older group (p <0.001). There were 4% of children in the younger group who did not attain normal vision and 25% in the older group (p=0.045).
Discussion: Vision screening in children younger than 3 years of age identifies similar numbers of children with amblyopia compared with ages 3 and older. The younger group attained normal vision at a significantly younger age and were more likely to attain normal vision in follow-up.
Conclusion: This study shows that earlier vision screening and referral leads to a better chance of attaining normal vision and at a younger age, thus providing evidence for vision screening in children under 3 years of age.
References: U.S. Preventive Services Task Force, Final Evidence Review: Vision in Children Ages 6 Months to 5 Years: Screening. September 2017. https://www.uspreventiveservicestaskforce.org/Page/Document/final-evidence-review/vision-in-children-ages-6-months-to-5-years-screening. Accessed September 20, 2017.