Whole-population vision screening in children aged 4-5 years to detect amblyopia

Lancet. 2015 Jun 6;385(9984):2308-19. doi: 10.1016/S0140-6736(14)60522-5. Epub 2014 Dec 10.


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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Amblyopia / diagnosis*
  • Amblyopia / epidemiology
  • Amblyopia / physiopathology
  • Child, Preschool
  • Female
  • Humans
  • Male
  • Mass Screening / standards*
  • Prevalence
  • Vision Screening / standards*
  • Visual Acuity