Screening for amblyopia and strabismus in children aged 4-5 years: where do we go from here?

Aim: To describe the history of vision screening for amblyopia and strabismus and identify knowledge gaps within the literature. Method: A review of the literature is presented which includes an examination of screening guidelines. Results: A recent Health Technology Appraisal reported that screening for amblyopia and amblyogenic factors was not cost-effective, and highlighted a need for further research into the impact of amblyopia and amblyogenic factors in the long-term. Despite recommendations to the contrary vision screening varies in content across the United Kingdom (UK), particularly with respect to personnel undertaking the screening tests. Conclusion: Uncertainty surrounding the appropriateness of vision screening remains, with areas of the literature still lacking in evidence to support screening programmes. Debate is needed as to the strategic approach of the orthoptic profession in the application of vision screening across the UK