Screening one- and two-year-olds for lazy eye can reliably
detect children at risk for vision problems, a new study suggests.
Researchers found tests by trained volunteers correctly
caught a similar proportion of toddlers and older preschoolers with the early
signs of lazy eye - also known as amblyopia - who were then referred to an
ophthalmologist for treatment.
"If you find a child (with vision problems) at five,
it's theoretically possible if you treat them that they will get better. It's
just that most people believe that waiting until they're three or four or five
is a long time, because amblyopia is set in," said Dr Susannah Longmuir,
an ophthalmologist who led the new study at the University of Iowa in Iowa
Detecting the problem
"Finding it early is generally believed to be
better," she said. However, not all researchers and
policymakers agree screening very young kids for vision problems is definitely
The US Preventive Services Task Force, a government-backed
panel, recommended in 2011 that kids age three to five be screened at least
once for lazy eye. But for babies and toddlers under three years old, the panel
said there wasn't enough evidence to weigh the possible benefits and harms of
Dr Michael LeFevre, co-vice chair of the USPSTF and a family
doctor at the University of Missouri School of Medicine in Columbia, said the
new study doesn't change that. "The principal research gap really related
to after one identifies abnormalities, whether treatment affects the
development of amblyopia," LeFevre, who wasn't involved in the new research, said.
Preventing long term
"We had evidence that treatment in the three- to
five-year age range prevents long term vision loss, but we didn't have any
evidence in the younger age range."A patch at two?? Treatment for lazy eye
- when one eye loses the ability to see details - usually involves covering up
the good eye or making it blurry with drops so the child is forced to use the
bad eye instead.
with amblyopia also need glasses to improve their vision."You can imagine
taking your two-year-old and having them run around with a patch on their eye,
how easy it is," LeFevre said. "It's hard enough at age three to
five."For the new study, Longmuir and her colleagues analysed the records
of more than 200 000 Iowa preschoolers who were screened for signs of lazy eye
between 2000 and 2011.
One-fifth of those kids were younger than three years at the
time of testing. Among babies less than one year old, a quarter of screening
tests were unreadable, the researchers found. But when they compared one- and
two-year-olds only with the older preschoolers, there was no difference in
screening accuracy, according to findings published Monday in Pediatrics.
Children who were
referred to an ophthalmologist
Between three and five percent of kids were referred to an
ophthalmologist for further testing and treatment, based on the free screening.
Doctors confirmed that as many as 90% of those positive screeners needed
Some states offer free vision screening for toddlers, but
the idea of eye checks in that age group is "a very debatable topic"
given the resources involved, according to Longmuir. Still, she and her
colleagues said parents should take advantage of those programs where they
exist - even if their child is younger than three years old. "If the
opportunity exists, go ahead and do it," Longmuir said.