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Evidence summaries

Screening for Amblyopia in Childhood

There is insufficient evidence of effectiveness from randomized controlled trials to support current vision screening programs for amblyopia. Level of evidence: "D"

In a Cochrane review [Abstract] 1 no trials designed to compare the prevalence of amblyopia in screened versus unscreened populations were found. The lack of data from randomised controlled trials makes it difficult to analyse the impact of existing screening programmes on the prevalence of amblyopia. The absence of such evidence cannot be taken to mean that vision screening is not beneficial; simply that this intervention has not yet been tested in robust trials.

Comment: Randomised controlled trials on this field have been considered virtually impossible to perform, because leaving a child with deep amblyopia in the control group would most probably not be accepted by the parents. Treatment of moderate amblyopia has been found worthwhile 2 whereas treatment of mild amblyopia did not lead to a significant improvement. The treatment of amblyopia is effective and inexpensive and if its screening is included in a health examination, its expenses are low.

References

  • Powell C, Hatt SR. Vision screening for amblyopia in childhood. Cochrane Database Syst Rev 2005 Jul 20;(3):CD005020 [Last assessed as up-to-date: 14 August 2008] [PubMed]
  • Clarke MP, Wright CM, Hrisos S, Anderson JD, Henderson J, Richardson SR. Randomised controlled trial of treatment of unilateral visual impairment detected at preschool vision screening. BMJ 2003 Nov 29;327(7426):1251. [PubMed]

Primary/Secondary Keywords