• Ameenat Lola Solebo, Phillippa M Cumberland, and Jugnoo S Rahi.
• Life Course Epidemiology and Biostatistics Section, UCL Institute of Child Health, London, UK; Ulverscroft Vision Research Group, UCL Institute of Child Health, London, UK; Moorfields Eye Hospital NHS Foundation Trust/NIHR Moorfields Biomedical Research Centre, London, UK; Institute of Ophthalmology, University College London, London, UK.
• Lancet. 2015 Jun 6; 385 (9984): 2308-19.

AbstractAmblyopia is a neurodevelopmental disorder that affects at least 2% of most populations and can lead to permanently reduced vision if not detected and treated within a specific period in childhood. Whole-population screening of children younger than 5 years is applied in many countries. The substantial diversity in existing programmes reflects their heterogeneous implementation in the absence of the complete evidence base that is now a pre-requisite for instituting screening. The functional importance of amblyopia at an individual level is unclear as data are scarce, but in view of the high prevalence the population-level effect might be notable. Screening of all children aged 4-5 years (eg, at school entry) confers most benefit and addresses inequity in access to timely treatment. Screening at younger ages is associated with increased risk of false-positive results, and at older ages with poor outcomes for children with moderate to severe amblyopia. We suggest that the real-life adverse effects of amblyopia should be characterised and screening and diagnosis should be standardised. Copyright © 2015 Elsevier Ltd. All rights reserved.

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