OWN - NLM
DA - 20170905
LR - 20170912
IS - 1538-3598 (Electronic)
IS - 0098-7484 (Linking)
VI - 318
IP - 9
DP - 2017 Sep 05
TI - Vision Screening in Children Aged 6 Months to 5 Years: US Preventive Services
Task Force Recommendation Statement.
PG - 836-844
LID - 10.1001/jama.2017.11260 [doi]
AB - Importance: One of the most important causes of vision abnormalities in children
is amblyopia (also known as "lazy eye"). Amblyopia is an alteration in the visual
neural pathway in a child's developing brain that can lead to permanent vision
loss in the affected eye. Among children younger than 6 years, 1% to 6% have
amblyopia or its risk factors (strabismus, anisometropia, or both). Early
identification of vision abnormalities could prevent the development of
amblyopia. Subpopulation Considerations: Studies show that screening rates among
children vary by race/ethnicity and family income. Data based on parent reports
from 2009-2010 indicated identical screening rates among black non-Hispanic
children and white non-Hispanic children (80.7%); however, Hispanic children were
less likely than non-Hispanic children to report vision screening (69.8%).
Children whose families earned 200% or more above the federal poverty level were
more likely to report vision screening than families with lower incomes.
Objective: To update the 2011 US Preventive Services Task Force (USPSTF)
recommendation on screening for amblyopia and its risk factors in children.
Evidence Review: The USPSTF reviewed the evidence on the accuracy of vision
screening tests and the benefits and harms of vision screening and treatment.
Surgical interventions were considered to be out of scope for this review.
Findings: Treatment of amblyopia is associated with moderate improvements in
visual acuity in children aged 3 to 5 years, which are likely to result in
permanent improvements in vision throughout life. The USPSTF concluded that the
benefits are moderate because untreated amblyopia results in permanent,
uncorrectable vision loss, and the benefits of screening and treatment
potentially can be experienced over a child's lifetime. The USPSTF found adequate
evidence to bound the potential harms of treatment (ie, higher false-positive
rates in low-prevalence populations) as small. Therefore, the USPSTF concluded
with moderate certainty that the overall net benefit is moderate for children
aged 3 to 5 years. Conclusions and Recommendations: The USPSTF recommends vision
screening at least once in all children aged 3 to 5 years to detect amblyopia or
its risk factors. (B recommendation) The USPSTF concludes that the current
evidence is insufficient to assess the balance of benefits and harms of vision
screening in children younger than 3 years. (I statement).
CN - US Preventive Services Task Force
FAU - Grossman, David C
AU - Grossman DC
AD - Kaiser Permanente Washington Health Research Institute, Seattle.
FAU - Curry, Susan J
AU - Curry SJ
AD - University of Iowa, Iowa City.
FAU - Owens, Douglas K
AU - Owens DK
AD - Veterans Affairs Palo Alto Health Care System, Palo Alto, California.
AD - Stanford University, Stanford, California.
FAU - Barry, Michael J
AU - Barry MJ
AD - Harvard Medical School, Boston, Massachusetts.
FAU - Davidson, Karina W
AU - Davidson KW
AD - Columbia University, New York, New York.
FAU - Doubeni, Chyke A
AU - Doubeni CA
AD - University of Pennsylvania, Philadelphia.
FAU - Epling, John W Jr
AU - Epling JW Jr
AD - Virginia Tech Carilion School of Medicine, Roanoke.
FAU - Kemper, Alex R
AU - Kemper AR
AD - Nationwide Children's Hospital, Columbus, Ohio.
FAU - Krist, Alex H
AU - Krist AH
AD - Fairfax Family Practice Residency, Fairfax, Virginia.
AD - Virginia Commonwealth University, Richmond.
FAU - Kurth, Ann E
AU - Kurth AE
AD - Yale University, New Haven, Connecticut.
FAU - Landefeld, C Seth
AU - Landefeld CS
AD - University of Alabama at Birmingham.
FAU - Mangione, Carol M
AU - Mangione CM
AD - University of California, Los Angeles.
FAU - Phipps, Maureen G
AU - Phipps MG
AD - Brown University, Providence, Rhode Island.
FAU - Silverstein, Michael
AU - Silverstein M
AD - Boston University, Boston, Massachusetts.
FAU - Simon, Melissa A
AU - Simon MA
AD - Northwestern University, Evanston, Illinois.
FAU - Tseng, Chien-Wen
AU - Tseng CW
AD - University of Hawaii, Honolulu.
AD - Pacific Health Research and Education Institute, Honolulu, Hawaii.
LA - eng
PT - Journal Article
PT - Practice Guideline
PL - United States
TA - JAMA
JT - JAMA
JID - 7501160
SB - AIM
SB - IM
MH - Advisory Committees
MH - Amblyopia/*diagnosis
MH - Anisometropia/diagnosis
MH - Child, Preschool
MH - False Positive Reactions
MH - Female
MH - Hispanic Americans
MH - Humans
MH - Infant
MH - Male
MH - Mass Screening
MH - Risk Assessment
MH - Risk Factors
MH - Strabismus/diagnosis
MH - United States
MH - *Vision Screening
EDAT- 2017/09/06 06:00
MHDA- 2017/09/13 06:00
CRDT- 2017/09/06 06:00
AID - 2652657 [pii]
AID - 10.1001/jama.2017.11260 [doi]
PST - ppublish
SO - JAMA. 2017 Sep 5;318(9):836-844. doi: 10.1001/jama.2017.11260.