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Automated eye screening better for children

In a released policy statement, the American Academy of Pediatrics (AAP) said that instrument-based vision screening is superior to visual acuity tests for children under the age of 4. One of the primary goals of such screening is to detect a neural deficit known as amblyopia (lazy eye), a condition characterized by decreased visual acuity and one that is not accounted for by ocular structure disorders . Approximately 1-4% percent of children may have this disorder or possess its risk factors. Instrument-based vision screening includes techniques that automatically evaluate vision. Photoscreening is one such recommended technique that uses images of the eye’s red reflex to estimate refractive error and other elements. The other primary technique is autorefraction, which utilizes automated skiascopy or wavefront technology to measure refractive error. These automated tests are quick and require little cooperation from the patient, making them more accurate for young children than standard visual acuity tests that depend on behavioral responses. This is especially true for developmentally delayed children, where few professionals can accurately determine visual acuity using standard vision charts. However, instrument-based vision screening involves significant cost to primary care practices, and payment from a third-party payer cannot be guaranteed. As a result, primary care physicians are likely to be slow in adopting these automated techniques to avoid incurring high costs.*

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