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Effectiveness of Screening Preschool Children for Amblyopia: A Systematic Review


Christine Schmucker, Robert Grosselfinger, Rob Riemsma, Gerd Antes, Stefan Lange, Wolf Lagréze and Jos Kleijnen


Institute for Quality and Efficiency in Health Care, Germany




BMC Ophthalmology


  • This systematic review focuses on the question of whether screening for amblyopia in children up to the age of six years leads to better vision outcomes.

  • Three out of five studies studies suggested that screening is associated with an absolute reduction in the prevalence of amblyopia between 0.9% and 1.6% (relative reduction: between 45% and 62%).

  • However, the studies showed weaknesses, limiting the validity and reliability of their findings.

  • The main limitation was that studies with significant results considered only a proportion of the originally recruited children in their analysis.

  • On the other hand, retrospective sample size calculation indicated that the power based on the cohort size was not sufficient to detect small changes between the groups.

  • Outcome parameters such as quality of life or adverse effects of screening have not been adequately investigated in the literature currently available.

  • Population based preschool vision screening programmes cannot be sufficiently assessed by the literature currently available.

  • However, it is most likely that the present systematic review contains the most detailed description of the main limitations in current available literature evaluating these programmes.

  • Therefore, future research work should be guided by the findings of this publication.