Evidence-Based Guidelines for Amblyogenic Risk Factors

IntroductionIn the absence of universally accepted guidelines for preschool vision screening, local and state mandates and recommendations vary considerably. In an effort to promote and protect the visual development of young children and to encourage uniform testing and reporting criteria, the Vision Screening Committee of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) felt compelled to develop responsible, evidence-based guidelines for the detection of amblyogenic risk factors. Risk factors include media opacities, ptosis, strabismus, unequal or significant refractive errors, and below standard visual acuity in one or both eyes.ResultsThe guidelines, as they pertain to anisometropia (> 1.50 D spherical or cylindrical), hyperopia (> 3.50 D in any meridian), astigmatism (> 1.5 D at 90° or 180° and > 1.0 D in oblique axis), and myopia (> 3.00 D in any meridian) are presented. The pivotal studies upon which the guidelines were based are discussed.ConclusionThe current guidelines have the endorsement of AAPOS, AACO, AAO, AAP, and AAFP; compliance is encouraged.