Vision screening outcomes in children less than 3 years of age compared with children 3 years and older

Abstract

To compare the rates of amblyopia and treatment outcomes in children 0-2years to those of children aged 3-5years referred from a well-established community-based photoscreening program. The medical records of children who failed vision photoscreening through Iowa KidSight and were subsequently seen at the University of Iowa for a complete eye examination over a 13-year period were retrospectively reviewed. Outcome measures were the number of children obtaining normal vision, the age at which normal vision was attained, and the elapsed time from screening examination to first documentation of normal vision. Of 319 subjects, 67 (21%) were 0-2years of age and 252 (79%) were at least 3years of age at screening. Amblyopia was found in 19% of the younger group and 30% of the older group (P=0.12). Follow-up time was similar between groups. At final follow-up, 8% of children in the younger group did not attain normal vision, compared with 40% in the older group (OR=8.92; 95% CI, 1.65-92.95; P=0.009). Normal vision was attained on average at 35months of age in the younger group and 69months in the older group (P<0.0001). In our study cohort, children <3years of age were found to have an equivalent rate of amblyopia compared with children ≥3 of age. Those screened between ages 0-2years of age attained normal vision at a significantly younger age and were more likely to attain normal vision.