Pediatric Vision Screening

Noelle S. Matta, CO, CRC, COT; David I. Silbert, MD, FAAP


Int Ophthalmol Clin. 2014;54(3):41-53. 

In This Article

Why We Need Pediatric Vision Screening

Pediatric vision screenings are essential to detect poor vision, refractive anomalies, and medically threatening eye disorders, most of which are treatable. Amblyopia, defined as reduced and uncorrected vision in a structurally normal eye, can be caused by significant refractive error, misalignment of the eyes, or deprivation such as visually significant ptosis (droopy eyelid) or a cataract.[1] It is well documented that children who receive pediatric vision screening have a decreased prevalence of amblyopia and ocular disorders when compared with an unscreened population.[2,3] Amblyopia is reversible with treatment during childhood, and it is generally believed that the earlier amblyopia risk factors are identified and amblyopia treatment is initiated, the more likely the child will develop normal vision.[4] Left untreated amblyopia can lead to a permanent reduction in vision in one or both eyes and is the leading cause of vision loss in adults under the age of 40 years.[5]

Pediatric vision screening is extremely cost effective. The cost of pediatric vision screening is approximately $10 to $21 per child. The cost/Qualy ratio for amblyopia screening is estimated at $6000. This is significantly less than the same metric for annual screening for diabetics for retinopathy, which is estimated at $231,000, and considered a mandatory practice by many health care insurers and organizations. It is estimated that a single comprehensive eye examination on all 4-year-old patients would cost approximately $485 million.[6] If children undergo 5 eye examinations from birth to the age of 10 years, as suggested by the American Optometric Association Guidelines, the cost would far exceed $1 billion.[7]