What are the recommended screening guidelines for amblyopia in children, and at what age should they be implemented?

Recommended screening guidelines for amblyopia in children involve early vision assessment primarily through orthoptic vision screening, typically implemented around the age of 4 years. In the UK, the National Screening Committee recommends orthoptic vision screening as part of the developmental assessment at 4 years (uncorrected age), especially for children born preterm or with risk factors, to identify amblyopia and other vision problems early ². This screening aims to detect visual acuity deficits and strabismus, which are common causes of amblyopia.

Screening before 4 years is generally conducted through universal child health surveillance, including vision checks during routine health visits, but formal orthoptic screening is emphasized at 4 years. This timing aligns with the developmental follow-up protocols that ensure children at risk receive comprehensive assessment, including vision screening, to facilitate timely intervention ².

International evidence, such as the Canadian clinical practice guidelines, supports periodic eye examinations starting from infancy up to 5 years, with particular attention to amblyopia risk factors and early detection through visual acuity testing and ocular alignment assessments (Joint Clinical Practice Guideline Expert Committee of the Canadian Association of Optometrists and the Canadian Ophthalmological Society et al., 2019). These guidelines recommend screening at multiple points in early childhood to optimize detection and treatment outcomes.

In summary, UK guidelines prioritize orthoptic vision screening at 4 years as a key time point for amblyopia detection, supported by universal vision checks earlier in childhood, while international literature suggests a broader age range for periodic screening to enhance early identification.