Referral thresholds for failed vision screening should be-revaluated

Although there has been an increase in referrals for failed vision screening (FVS) among younger children, the rate of prescribing glasses for children under 2 remains very low, according to data presented at the 2023 AAPOS Annual Meeting, which suggested referral thresholds should be re-evaluated.

The study looked at 87,771 clinical records of 63,301 children to determine prescribing rates for glasses based on refractive errors and age. The study found that glasses prescribing was low before age 12 months, and prescribing thresholds decreased gradually with age across all refractive-error categories. Refractive-error specific prescribing rates did not change significantly between 2009-2015 and 2016-2022.

For children with frequent vision screening (FVS), prescribing rates were 4%, 13%, 26%, and 48-50% for ages <1 year, 1-2 years, 2-3 years, and 3-18 years, respectively. Before age 2, prescribing rates were over 60% only for specific refractive errors, and 90% of FVS referrals before age 2 did not meet these thresholds.

Reference
Lee YH, et al. Failed Vision Screenings and Childhood Refractive Errors: When Do We Actually Prescribe Glasses? Presented at: 2023 AAPOS Annual Meeting.