Purpose of review: The diagnosis and successful treatment of visually significant refractive errors in children are a subject of continued study and debate.
Recent findings: Treatment of significant refractive errors is widely accepted to reduce lifelong vision loss from amblyopia. Children aged 3-5 years may be screened for unexplained vision loss, refractive errors and amblyogenic factors using traditional eye charts as well as newer modalities such as autorefractors and photoscreeners. The accuracy of various screening methods is variable throughout the literature. Debate remains as to who is best suited to administer vision screening tests. Compliance with follow-up with an eye-care professional once a child is identified with an amblyogenic factor remains suboptimal. Treatment of significant refractive errors in certain populations of pediatric patients with refractive surgery shows promise but requires further study.
Summary: The timely diagnosis of significant refractive errors in children remains a significant challenge, especially for ages 3-5 years, but treatment may provide significant improvement of visual acuity and quality of life.