Amblyopia Screening Research Articles

The Prevalence of Amblyopia, Strabismus, and Ptosis in Schoolchildren of Dezful.

Purpose To determine the prevalence of amblyopia, strabismus, and ptosis among schoolchildren in Dezful in the west of Iran. Methods In this cross-sectional study, 1,375 schoolchildren of Dezful were selected through multistage cluster sampling. After obtaining written consents, participants had uncorrected and corrected visual acuity tests, cycloplegic refraction, and the cover test, and were examined for ptosis at the school site. Results Of the 1,151 study participants (83.7%), examinations were completed for 1,130 schoolchildren. Prevalence rates of amblyopia, strabismus, and ptosis were 2.7% (95% confidence interval [CI] 0.8-4.7), 1.9% (95% CI: 0.2-3.8), and 0.8%, respectively. Anisometropia was the most common cause of amblyopia; 45.2% of cases had anisometropic amblyopia. Among cases with strabismus, 63.6% were exotropic and 36.4% were esotropic. Conclusion The present study indicated that the prevalence of amblyopia and strabismus in Dezful schoolchildren falls in the average range. Since the Amblyopia Screening Program has been running for years, we expected lower rates compared to previous years, but this was not observed. Correcting refractive errors can significantly reduce amblyopic cases.

Patient-reported utilities in bilateral visual impairment from amblyopia and age-related macular degeneration.

BackgroundUtility of visual impairment caused by amblyopia is important for the cost-effectiveness of screening for amblyopia (lazy eye, prevalence 3–3.5 %). We previously measured decrease of utility in 35-year-old persons with unilateral persistent amblyopia. The current observational case–control study aimed to measure loss of utility in patients with amblyopia with recent decrease of vision in their better eye. As these patients are rare, the sample was supplemented by patients with bilateral age-related macular degeneration with similar decrease of vision.MethodsFrom our out-patient department, two groups of patients with recent deterioration to bilateral visual acuity less than Snellen 0.5 (bilateral visual impairment, BVI) were recruited, with either persistent amblyopia and age-related macular degeneration (AMB + AMD), or with bilateral age-related macular degeneration (BAMD). To measure utility, the time trade-off method and the standard gamble method were applied through interviews. Correlations were sought between utility values and visual acuity, age and Visual Function Questionnaire-25 scores.ResultsSeventeen AMB + AMD patients (mean age 72.9 years), and 63 BAMD patients (mean age 79.6 years) were included in the study. Among AMB + AMD, 80 % were willing to trade lifetime in exchange for cure. The overall mean time trade-off utility was 0.925. Among BAMD, 75 % were willing to trade, utility was 0.917. Among AMB + AMD, 38 % accepted risk of death in exchange for cure, overall mean standard gamble utility was 0.999. Among BAMD, 49 % accepted risk of death, utility was 0.998. Utility was not related to visual acuity but it was to age (p = 0.02).ConclusionElderly patients with BVI, caused by persistent amblyopia and age-related macular degeneration (AMD) or by bilateral AMD, had an approximately 8 % loss of TTO utility. Notably, the 8 % loss in elderly with BVI differs little from the 3.7 % loss we found previously in 35-year-old persons with unilateral amblyopia with good vision in the other eye. The moderate impact of BVI in senescence could be explained by adaptation, comorbidity, avoidance of risk and a changed percept of cure.

Zagreb Amblyopia Preschool Screening Study: near and distance visual acuity testing increase the diagnostic accuracy of screening for amblyopia.

AimTo present and evaluate a new screening protocol for amblyopia in preschool children.MethodsZagreb Amblyopia Preschool Screening (ZAPS) study protocol performed screening for amblyopia by near and distance visual acuity (VA) testing of 15 648 children aged 48-54 months attending kindergartens in the City of Zagreb County between September 2011 and June 2014 using Lea Symbols in lines test. If VA in either eye was >0.1 logMAR, the child was re-tested, if failed at re-test, the child was referred to comprehensive eye examination at the Eye Clinic.Results78.04% of children passed the screening test. Estimated prevalence of amblyopia was 8.08%. Testability, sensitivity, and specificity of the ZAPS study protocol were 99.19%, 100.00%, and 96.68% respectively.ConclusionThe ZAPS study used the most discriminative VA test with optotypes in lines as they do not underestimate amblyopia. The estimated prevalence of amblyopia was considerably higher than reported elsewhere. To the best of our knowledge, the ZAPS study protocol reached the highest sensitivity and specificity when evaluating diagnostic accuracy of VA tests for screening. The pass level defined at ≤0.1 logMAR for 4-year-old children, using Lea Symbols in lines missed no amblyopia cases, advocating that both near and distance VA testing should be performed when screening for amblyopia.

Amblyopia Prevention Screening Program in Northwest Iran (Ardabil).

Background:The aim of this study was to evaluate the results of amblyopia screening in Ardabil Province in three examination levels by kindergarten teacher, optometrist, and ophthalmologist.Methods:In a cross-sectional study, the results of the national amblyopic prevention program in 2–6 years old children in Ardabil Province were investigated in 2012. The results pertained to the examinations of children participating in this research were collected in the national approved forms. The data were entered into the computer and were analyzed using statistical methods in SPSS 18.Results:Around 38,844 children (51.7%) out of 75173 with 2–6 years old qualified children participated in the screening program in Ardabil Province. In the first stage of screening, 1068 children (33.1%) are visually impaired in one eye and 2160 children (66.9%) are visually impaired in two eyes. In the second stage, the results related to the examinations by optometrists indicated that the prevalence of refractive errors, strabismus, and others were 70%, 27.8%, and 2.2%, respectively. Refractive errors problem was most prevalent in Ardabil city (72.6%).The prevalence of refractive errors, strabismus, and other reasons in amblyopic children was 51.3%, 23.9%, and 24.8%; respectively.Conclusions:The present investigation showed that coverage of amblyopia screening program was not enough in Ardabil Province. To increase the screening accuracy, standard instruments and examination room must be used; more optometrists must be involved in this program and increasing the validity of obtained results for future programming.

High specificity of the Pediatric Vision Scanner in a private pediatric primary care setting

To determine the specificity of the Pediatric Vision Scanner, a binocular retinal birefringence scanner, in its intended setting, a pediatric primary care office. A total of 102 preschool children (age 2-6 years) were screened during a well-child pediatric visit using the Pediatric Vision Scanner and the SureSight Autorefractor and completed a masked comprehensive pediatric ophthalmic examination (gold standard examination). Based on the gold standard examination, one child had anisometropic amblyopia, and the remaining 101 had no amblyopia or strabismus. Specificity of the Pediatric Vision Scanner was 90% (95% CI, 82%-95%) while specificity of the SureSight was 87% (95%CI, 79-93%). Combining these results with the sensitivity of the devices determined in our previous study conducted in a pediatric ophthalmology office setting, the positive likelihood ratio for the Pediatric Vision Scanner was 10.2; for the SureSight, 5.0. The negative likelihood ratio for the Pediatric Vision Scanner was 0.03; for the SureSight, 0.42, a significant difference. The Pediatric Vision Scanner had high specificity (90%) in screening for amblyopia and strabismus as part of a pediatric well-child visit. Likelihood ratio analysis suggests that affected children have a high probability of being correctly identified by the Pediatric Vision Scanner. The high level of confidence conferred by Pediatric Vision Scanner screening may remove an important barrier to vision screening in pediatric primary care.

The Sensitivity, Specificity and Predictive Values of Snellen Chart Compared to the Diagnostic Test in Amblyopia Screening Program in Iran

Introduction Amblyopia is a leading cause of visual impairment in both childhood and adult populations. Our aim in this study was to assess the epidemiological characteristics of the amblyopia screening program in Iran. Materials and Methods A cross-sectional study was done on a randomly selected sample of 4,636 Iranian children who were referred to screening program in 2013 were participated in validity study, too. From each provinces the major city were selected. Screening and diagnostic tests were done by instructors in first stage and optometrists in second stage, respectively. Finally data were analyzed by Stata version 13. Results The sensitivity was ranged from 74% to 100% among the various provinces such that Fars and Ardabil province had maximum and minimum values, respectively. The pattern of specificity was differ and ranged 44% to 84% among the provinces; Hormozgan and Fars had maximum and minimum values, respectively. The positive predictive value was also ranged from 35% to %81 which was assigned to Khuzestan and Ardabil provinces, respectively. The range of Negative Predictive value was 61% to 100% which was belonged to Ardabil and Fars provinces. Conclusion The total sensitivity (89%) and negative predictive values (93%) of screening test among children aged 3-6 years is acceptable, but only 51% of children refereed to second stage are true positive and this imposes considerable cost to health system.

Ocular Complications in Children with Diabetes Mellitus

The effectiveness of annual eye examinations in diabetic children is unclear. We sought to determine the prevalence and onset of ocular pathology in children with diabetes mellitus (DM), identify risk factors for ocular disease, and recommend a screening regimen for asymptomatic children. Retrospective, consecutive cohort study. Children aged less than 18 years with type 1 or 2 DM examined over a 4-year period. All children underwent a complete eye examination, including dilated fundoscopy and cycloplegic refraction. A literature review was performed, identifying the youngest reported age and shortest reported duration of DM before the diagnosis of diabetic retinopathy (DR). Prevalence of DR, cataract, high refractive error, and strabismus. A total of 370 children (mean age, 11.2 years; range, 1-17.5 years) had 693 examinations, with a mean DM duration of 5.2 years (range, 0.1-16.2 years) and a mean hemoglobin A1c (HbA1c) of 8.6 (range, 5-≥14). No children had DR. A total of 12 children had cataract; 5 required extraction but were identified by decreased vision, not diabetic screening. A total of 19 children had strabismus; only 1 was microvascular paralytic strabismus. A total of 41 children had high refractive error. There were no associations between these conditions and duration or control of DM. In the literature, the youngest age at diagnosis of severe DR was 15 years, and the shortest duration of disease was 5 years. Diabetic retinopathy is rare in children regardless of duration and control of DM. On the basis of our study and literature review, screening examinations for type 1 diabetes could begin at age 15 years or at 5 years after the diagnosis of DM, whichever occurs later, unless the child is judged by the endocrinologist as being at unusually high risk. Other ocular complications are identifiable through existing amblyopia screening methods.

Community-based amblyopia screening program for early detection in Iran: a repeated cross-sectional study from 1996 to 2013

M. Rafiei , F. Rivakani , L. Torabi , F. Alaeddini , S. Safiri c,d,* a Disability Prevention, State Welfare Organization (SWO) of Iran, Iran b Medical Procurement Organization, Iranian Red Crescent Society, Iran c Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran d Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Discriminating anisometropic amblyopia from myopia based on interocular inhibition

Amblyopia screening during childhood is critical for early detection and successful treatment. In the current study, we develop and evaluate a screening method that exploits the imbalanced interocular inhibition between amblyopic and fellow eyes. In nineteen subjects with anisometropic amblyopia and twenty-two age-matched subjects with myopia, we measured the area under the contrast sensitivity functions (AUCSFs) in eight monocular conditions defined by the tested eye (left, right), patching of the untested eye (translucent, opaque), and refractive status (corrected, uncorrected). For each tested eye, we defined the inhibition index as the ratio between the AUCSF values obtained in the translucent and opaque patching conditions of the untested eye. To evaluate the screening potential of the inhibition index, we compared results from patients with amblyopia and myopia. With and without optical correction, the index was significantly lower in the amblyopic eye than in the fellow eye of the amblyopic subjects and both eyes of the myopic subjects. No significant difference was found among the two eyes of the myopic subjects and the fellow eyes of the amblyopic subjects. With the inhibition index as the predictor, a logistic regression model successfully discriminated amblyopic eyes from myopic eyes with 100% accuracy in the uncorrected condition. In the corrected condition, with the inhibition index and interocular visual acuity difference as predictors, amblyopic eyes were likewise discriminated from myopic eyes with 100% accuracy. This pattern of CSF changes, caused by the different patching modes of the untested eye, provides a potential CSF signature to discriminate anisometropic amblyopia from myopia.

Screening, confirming, and treating amblyopia based on binocularity.

Screening, confirming, and treating amblyopia based on binocularity.

Amblyopia screening in children in Bandar Abbas (Iran) during 2011-2012.

Background:Amblyopia is an acquired defect of vision caused by abnormal visual experience that occurs during childhood. Since early diagnosis is important in preventing further irreparable effects, the aim of this study was to investigate the outcome of amblyopia screening in children.Methods:Data from the amblyopia screening program in the Welfare Department of Bandar Abbas during 2011–2012 were used. Suspected cases were referred to specialists in the Optometry clinic for screening purposes. Subsequently, patients who suffered from strabismus, amblyopia, or refractive errors were referred to ophthalmologists. SPSS version16 was used to analyze the data. The significance level was set at P < 0.05.Results:Of the 16,599 children examined in 2012, 2486 suspected cases of amblyopia were diagnosed and 168 being diagnosed with amblyopia after visit with ophthalmologist. The prevalence rate of amblyopia was 1.01%. In 2011, of 17,733 cases, 2013 children were diagnosed as suspected cases and 171 patients were diagnosed to be amblyopic finally.Conclusions:The prevalence of amblyopia in this study was 0.96% and 1.01% in years 2011 and 2012 respectively, which was consistent with the results of studies in other countries. By considering the importance of diagnosing the prevalence of amblyopia on time in preschool and in order to prevent children`s low vision or blindness in future, it is essential to increase the quality of the examinations that are conducted by the trainers.

Amblyopia screening in Bulgaria.

To determine the prevalence of amblyopia and the average age at first ophthalmological examination of school-aged children from northwestern Bulgaria. Visual acuity testing, stereopsis, orthoptics, ocular motility, non-cycloplegic refraction, direct ophthalmoscopy, and external ocular inspection were performed. Cycloplegic refraction and indirect ophthalmoscopy were done as necessary. A total of 2,054 children (1,020 girls and 1,034 boys) were divided into three age groups: 6 to 8 years (803 children), 8 to 10 years (719 children), and 10 to 12 years (530 children). A total of 1,861 children (90.6%) received their first examination: 754 (93.9%) aged 6 to 8 years, 638 (88.7%) aged 8 to 10 years, and 469 (88.2%) aged 10 to 12 years. Amblyopia was detected in 88 children (4.3%): 42 (5.2%) aged 6 to 8 years, 27 (3.8%) aged 8 to 10 years, and 19 (3.6%) aged 10 to 12 years. The first group had higher prevalence compared to countries with well-developed screening programs. Refractive errors were detected in 403 children (19.7%): 125 (15.6%) aged 6 to 8 years, 146 (20.3%) aged 8 to 10 years, and 132 (24.8%) aged 10 to 12 years. The estimated prevalence increases with age. Strabismus was detected in 24 children (1.2%): 8 (1.0%) aged 6 to 8 years, 7 (1.0%) aged 8 to 10 years, and 9 (1.7%) aged 10 to 12 years. The lack of screening programs in Bulgaria is the main reason for late diagnosis of amblyopia. The "Do Good "project provided eye examination of school-aged children aged 6 to 12 years, when amblyopia is curable. This model could be used in establishing a Bulgarian national screening program.

Pediatric vision screening.

International Ophthalmology Clinics: Summer 2014 - Volume 54 - Issue 3 - p 41-53 doi: 10.1097/IIO.0000000000000034

Refractive Errors in 3–6 Year-Old Chinese Children: A Very Low Prevalence of Myopia?

PurposeTo examine the prevalence of refractive errors in children aged 3–6 years in China.MethodsChildren were recruited for a trial of a home-based amblyopia screening kit in Guangzhou preschools, during which cycloplegic refractions were measured in both eyes of 2480 children. Cycloplegic refraction (from 3 to 4 drops of 1% cyclopentolate to ensure abolition of the light reflex) was measured by both autorefraction and retinoscopy. Refractive errors were defined as followed: myopia (at least −0.50 D in the worse eye), hyperopia (at least +2.00 D in the worse eye) and astigmatism (at least 1.50 D in the worse eye). Different definitions, as specified in the text, were also used to facilitate comparison with other studies.ResultsThe mean spherical equivalent refractive error was at least +1.22 D for all ages and both genders. The prevalence of myopia for any definition at any age was at most 2.5%, and lower in most cases. In contrast, the prevalence of hyperopia was generally over 20%, and declined slightly with age. The prevalence of astigmatism was between 6% and 11%. There was very little change in refractive error with age over this age range.ConclusionsPrevious reports of less hyperopic mean spherical equivalent refractive error, and more myopia and less hyperopia in children of this age may be due to problems with achieving adequate cycloplegia in children with dark irises. Using up to 4 drops of 1% cyclopentolate may be necessary to accurately measure refractive error in paediatric studies of such children. Our results suggest that children from all ethnic groups may follow a similar pattern of early refractive development, with little myopia and a hyperopic mean spherical equivalent over +1.00 D up to the age of 5–6 yearsin most conditions.

Effectiveness of screening for amblyopia and other eye disorders in a prospective birth cohort study

To establish whether the current vision screening practice in the Netherlands is effective in preventing permanent visual loss and to estimate the sensitivity of the programme. In the Netherlands, all children are invited for preverbal (1, 3, 6-9 and 14-24 months) and preschool (36, 45, and 60-72 months) vision screening. Screening attendance is high, but the effectiveness in reducing amblyopia is unknown. In a 7-year cohort study, 4624 children born in the city of Rotterdam between 16 September 1996 and 15 May 1997 were followed through all routine vision screening examinations. At age seven, visual acuity (VA) of children still living in Rotterdam was assessed by study orthoptists. In case of VA > 0.1 logMAR in one or both eyes, two or more logMAR lines of interocular difference or eye disorders like strabismus, children underwent a more intensive eye examination. Attendance at the 9-month screening was 89%, decreasing to about 75% at later examinations. Of preverbal tests, 2.5% were positive, and of preschool tests, 10%. In total, 19% of children had a positive vision screening test at least once. Amblyopia prevalence was 3.4%. Sensitivity of the vision screening programme was 73% and specificity 83%. At age seven, 0.7-1.2% (confirmed vs final exam) of the children had a VA > 0.3 logMAR in the worse eye compared with 2-3.9% (in literature) reported prevalence in non-screening situations. Children who were less frequently screened had a higher chance of poor vision (>0.3 logMAR) at age seven. The Dutch child vision screening programme may reduce the risk of persistent amblyopia (VA > 0.3 logMAR) at age seven by more than half.

Amblyopia Risk Factor Prevalence

In 2003, the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) published a set of risk factors for amblyopia. The intent was to promote uniformity of reporting and development in screening. Because this prevalence is not yet known, this meta-analysis is an attempt to estimate it. Major community preschool eye examination studies were reviewed and AAPOS cut-offs estimated. The approximate prevalence of anisometropia is 1.2%, hyperopia is 6%, astigmatism is 15%, myopia is 0.6%, strabismus is 2.5%, and visual acuity less than 20/40 is 6%. The mean combined prevalence is 21% ± 2% compared to a prevalence of amblyopia 20/40 and worse of 2.5%. Knowing risk factor prevalence simplifies validation efforts. Amblyopia screening with a risk factor sensitivity less than 100% is expected and desirable.

Screening for amblyopia among grade-1 students in primary school with uncorrected vision and stereopsis test in central China

Background Screening for amblyopia at earliest is important for early treatment and better prognosis. This study aimed to evaluate the validity of uncorrected distant and near visual acuity (VA) and stereoacuity for screening amblyopia in grade-1 students in primary school in central China. Methods By stratified cluster sampling, 3112 grade-1 students from 11 Anyang primary schools were selected for the study. All the participants underwent uncorrected distant and near VA, stereopsis test, cycloplegic refraction, best corrected VA (BCVA), cover test, and ocular movement examination. VA was measured with a logarithm of the minimum angle of resolution (logMAR) chart. Stereoacuity was measured with the Lang II stereo card and TNO test. Amblyopia was defined as the BCVA less than or equal to 0.1 logMAR units of any eye in the absence of significant pathological abnormalities. The sensitivity, specificity, and positive and negative predictive value of uncorrected VA and stereoacuity for amblyopia were analyzed. Results Out of the 3112 eligible students, 2893 (92.96%) completed the examinations. The average age of the students was (7.10t0.41) years. Screened by distant VA with low cutoff (logMAR 0.1), high cutoff (logMAR 0.0), and near VA (logMAR 0.0), 31.64%, 73.18%, and 50.23% students were abnormal, respectively. Screened by stereopsis test, only 4.69% students were abnormal. Diagnosed by a senior pediatric ophthalmologist, 61 students had amblyopia. The sensitivities of distant VA with low/high cutoff and near VA were 92.31%, 100%, and 80.77%, respectively, whereas that of stereoacuity by TNO test was 15.38%. Simultaneous testing of either two of the three tests improved the sensitivity. Conclusions Distant VA test of high cutoff alone displays a high sensitivity but a low specificity. Simultaneous testing of distant VA of low cutoff and stereoacuity is a better choice to balance between sensitivity and specificity.

ICheckKids, SPOT, iScreen, and Plusoptix performance in a high-risk, young pediatric eye practice

Practical pediatric objective screening devices have improved at the same time the 99174 procedure code came into use. Pediatricians, concerned with practicality and validity, are asking “Which photoscreener should we get?” A new addition by iCheckHC makes use of an iPhone with software to over-ride the red-eye reduction preflash and collect patient data. Consecutive young patients in a pediatric eye practice had comprehensive exams and four state-of-the-art photoscreeners (iScreen, Pediavision SPOT, Plusoptix A09 and iCheckKids) consistent with the 2003 AAPOS Vision screen Amblyopia Risk Factor guidelines. 96 patients aged 6-130 months (mean 46 months) had prescreening probability 53%. The Sensitivity/specificity for each was: iScreen 78%/92%, SPOT 77%/87%, Plusoptix 83%/90% and the iCheckKids with DCC interpretation: 80%/93%. Additional statistics highlight the impact of inconclusive screen interpretations. These devices performed well. Each device has advantages with adjustable interpretation by Plusoptix and SPOT, rapid aim and image with online interpretation with iScreen and hand-held portability with iCheckKids. All devices are expected to improve with enhanced interpretation paradigms. Additional validation efforts include pediatric offices and community screening. Recent developments in devices and interpretation promise to improve early screening for amblyopia.

Beyond photography: Evaluation of the consumer digital camera to identify strabismus and anisometropia by analyzing the Bruckner′s reflex

Amblyopia screening is often either costly or laborious. We evaluated the Canon Powershot TX1 (CPTX1) digital camera as an efficient screener for amblyogenic risk factors (ARF). We included 138 subjects: 84-amblyopes and 54-normal. With the red-eye-reduction feature off, we obtained Bruckner reflex photographs of different sized crescents which suggested anisometropia, while asymmetrical brightness indicated strabismus; symmetry implied normalcy. Eight sets of randomly arranged 138 photographs were made. After training, 8 personnel, marked each as normal or abnormal. Of the 84 amblyopes, 42 were strabismus alone (SA), 36 had anisometropia alone (AA) while six were mixed amblyopes (MA). Overall mean sensitivity for amblyopes was 0.86 (95% CI: 0.83-0.89) and specificity 0.85 (95% CI: 0.77-0.93). Sub-group analyses on SA, AA and MA returned sensitivities of 0.86, 0.89 and 0.69, while specificities were 0.85 for all three. Overall Cohen's Kappa was 0.66 (95% CI: 0.62-0.71). The CPTX1 appears to be a feasible option to screen for ARF, although results need to be validated on appropriate age groups.

Validation and Cost-effectiveness of a Home-Based Screening System for Amblyopia

To investigate the cost-effectiveness of a novel home-based screening system for amblyopia and amblyogenic risk factors. Evaluation of diagnostic test or technology. Two thousand four hundred forty-two preschoolers 3 to 6 years of age from 10 kindergartens randomly selected from Guangzhou participated in the study in 2009. Preschoolers were assessed for amblyopia and amblyogenic risk factors by their parents using the home-based screening system and were re-evaluated by professionals who conducted a comprehensive eye examination. Sensitivity, specificity, positive predictive value, negative predictive value, and the cost-benefit of the home-based screening system were calculated by comparing the results from the home-assessed model and those from the professional evaluation. Three thousand three hundred children were invited to participate in the study, and 2308 (1216 boys and 1092 girls) completed all of the procedures. Twenty-four amblyopes were found by professional examinations. Fifteen of these amblyopes had not been diagnosed previously, and 12 of them were detected by the home-assessment model. The sensitivity, specificity, positive predictive value, and negative predictive value were 80.0%, 94.1%, 8.2%, and 99.9%, respectively. Professional examinations cost an average of US $1131.00 per case of amblyopia detected, whereas the cost was only US $266.00 per case for the home-based method. For amblyogenic factors, 50, 87, and 96 children were classified into grade I, II, or III according to the professional examinations. The corresponding numbers in the home-based system were 23, 29, and 15, respectively. Accordingly, the true positive rates were 46.0%, 33.3%, and 15.6% for each grade. The home-based amblyopia screening system was found to be a simple, effective, and cost-beneficial method for amblyopia screening and amblyogenic risk factors. The approach offers a practical option for developing areas with large populations. The author(s) have no proprietary or commercial interest in any materials discussed in this article.