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Guide answers 5 questions pediatricians have on instrument-based vision screening :

December 26, 2016

A new AAP-endorsed guide can help pediatricians incorporate instrument-based vision screening in the office.

The downloadable guide (, from the Children’s Eye Foundation of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS), is based on a 2016 policy statement from the Academy and others on evaluation of the eyes and visual system of newborns through teens (see resources).  

A Practical Guide for Primary Care Physicians: Instrument-Based Vision Screening in Children focuses on “five essential things” from the policy:

1. why pediatric vision screening is important;

2. what the 2016 statement says about instrument-based screening;

3. whether such screening and assessment are reimbursed as a covered service;

4. how to incorporate instrument-based screening in practice, which includes a link to help compare screening devices; and

5. information on an AAPOS handout for parents that includes a section for clinicians to add the result of a vision screening performed on a child that day.

The policy recommends clinicians try instrument-based vision screening in the office when children are between 1-3 years of age and at annual well-child visits thereafter, until acuity can be tested directly. Direct testing of visual acuity often can begin by age 4 using age-appropriate symbols. Children with an ocular abnormality or who fail a vision assessment should be referred to a pediatric ophthalmologist or eye care specialist appropriately trained to treat pediatric patients.

Amblyopia, the most common cause of visual impairment among young children, is a common cause of vision loss in adults but frequently is treatable if caught early. Because of the difficulty detecting amblyopia, hundreds of thousands of U.S. children —and millions around the world — lose their vision every year, according to the guide.


January 2016 AAP News article “New reports shine light on vision screening for primary care offices,”, includes links to AAP policy statement Visual System Assessment in Infants, Children and Young Adults by Pediatricians and clinical report Procedures for the Evaluation of the Visual System by Pediatricians.

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