title: Whole-population vision screening in children aged 4-5 years to detect amblyopia.
abstract: Amblyopia is a neurodevelopmental disorder that affects at least 2% of most populations and can lead to permanently reduced vision if not detected and treated within a specific period in childhood. Whole-population screening of children younger than 5 years is applied in many countries. The substantial diversity in existing programmes reflects their heterogeneous implementation in the absence of the complete evidence base that is now a pre-requisite for instituting screening. The functional importance of amblyopia at an individual level is unclear as data are scarce, but in view of the high prevalence the population-level effect might be notable. Screening of all children aged 4-5 years (eg, at school entry) confers most benefit and addresses inequity in access to timely treatment. Screening at younger ages is associated with increased risk of false-positive results, and at older ages with poor outcomes for children with moderate to severe amblyopia. We suggest that the real-life adverse effects of amblyopia should be characterised and screening and diagnosis should be standardised.
authors.affiliation: Life Course Epidemiology and Biostatistics Section, UCL Institute of Child Health, London, UK; Ulverscroft Vision Research Group, UCL Institute of Child Health, London, UK; Moorfields Eye Hospital NHS Foundation Trust/NIHR Moorfields Biomedical Research Centre, London, UK; Institute of Ophthalmology, University College London, London, UK.
authors.forename: Ameenat Lola
authors.initials: AL
authors.lastname: Solebo
authors.affiliation: Life Course Epidemiology and Biostatistics Section, UCL Institute of Child Health, London, UK; Ulverscroft Vision Research Group, UCL Institute of Child Health, London, UK.
authors.forename: Phillippa M
authors.initials: PM
authors.lastname: Cumberland
authors.affiliation: Life Course Epidemiology and Biostatistics Section, UCL Institute of Child Health, London, UK; Ulverscroft Vision Research Group, UCL Institute of Child Health, London, UK; Moorfields Eye Hospital NHS Foundation Trust/NIHR Moorfields Biomedical Research Centre, London, UK; Institute of Ophthalmology, University College London, London, UK; Great Ormond Street Hospital/Institute of Child Health Biomedical Research Centre, London, UK. Electronic address: j.rahi@ucl.ac.uk.
authors.forename: Jugnoo S
authors.initials: JS
authors.lastname: Rahi
mesh_terms: D000550:Amblyopia / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D015995:Prevalence; D015351:Vision Screening / Q000592:standards*; D014792:Visual Acuity