Abstract：
In 2003 the American Association for Pediatric Ophthalmology and Strabismus Vision Screening Committee proposed criteria for automated preschool vision screening. Recent literature from epidemiologic and natural history studies, randomized controlled trials of amblyopia treatment, and field studies of screening technologies have been reviewed for the purpose of updating these criteria. The prevalence of amblyopia risk factors (ARF) is greater than previously suspected; many young children with low-magnitude ARFs do not develop amblyopia, and those who do often respond to spectacles alone. High-magnitude ARFs increase the likelihood of amblyopia. Although depth increases with age, amblyopia remains treatable until 60 months, with decline in treatment effectiveness after age 5. US Preventive Services Task Force Preventative Services Task Force guidelines allow photoscreening for children older than 36 months of age. Some technologies directly detect amblyopia rather than ARFs. Age-based criteria for ARF detection using photoscreening is prudent: referral criteria for such instruments should produce high specificity for ARF detection in young children and high sensitivity to detect amblyopia in older children. Refractive screening for ARFs for children aged 12-30 months should detect astigmatism >2.0 D, hyperopia >4.5 D, and anisometropia >2.5 D; for children aged 31-48 months, astigmatism >2.0 D, hyperopia > 4.0 D, and anisometropia >2.0 D. For children >49 months of age original criteria should be used: astigmatism >1.5 D, anisometropia>1.5 D, and hyperopia >3.5 D. Visually significant media opacities and manifest (not intermittent) strabismus should be detected at all ages. Instruments that detect amblyopia should report results using amblyopia presence as the gold standard. These new American Association for Pediatric Ophthalmology and Strabismus Vision Screening Committee guidelines will improve reporting of results and comparison of technologies.
摘要：
2003年，美国儿科眼科和斜视视力筛查委员会提出了自动学龄前视力筛查的标准。流行病学和自然史研究的最新文献，弱视治疗的随机对照试验，为了更新这些标准，已经审查了筛查技术的现场研究。弱视危险因素（ARF）的患病率高于以前的怀疑；许多低幅度ARF的幼儿不会发展为弱视，以及那些经常独自对眼镜作出反应的人。高量级ARFs增加弱视的可能性。虽然深度随着年龄的增长而增加，弱视在60个月前仍可治疗，5岁后治疗效果下降。美国预防服务工作组预防服务工作组指南允许对36个月以上的儿童进行照片筛查。一些技术直接检测弱视而不是ARFs。使用光学筛查进行ARF检测的基于年龄的标准是谨慎的：此类仪器的转诊标准应对幼儿的ARF检测产生高度特异性，并对大龄儿童的弱视检测产生高度敏感性。对12-30个月儿童的ARFs进行屈光筛查，应检测散光>2.0D，远视>4.5D，屈光参差>2.5D；对于31-48个月的儿童，散光>2.0D，远视>4.0D，和屈光参差>2.0D。对于年龄>49个月的儿童，应使用原始标准：散光>1.5D，屈光参差>1.5D，和远视>3.5D。应在所有年龄段检测到明显的中膜混浊和明显（非间歇性）斜视。检测弱视的仪器应报告使用弱视存在作为金标准的结果。这些新的美国儿科眼科协会和斜视视力筛查委员会指南将改善结果报告和技术比较。
