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Alaska Blind Child Discovery

A cooperative, charitable research project to vision screen every preschool Alaskan

Early Objective Screening

  Photoscreening and remote autorefraction can be successfully performed on very young children. this inlcudes nursery aged (2-4 years) when acuity testing can be done only by expert screeners with cooperative children, toddlers (aged 12-24 months) who cannot yet perform patching acuity, and infants aged birth to 12 months. To determine if early objective screening is better than waiting until children are older than 4 years and able to practically perform acuity testing, it takes large-scale studies with long-term follow-up.  
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  Janette Atkinson, et al videorefracted infants aged 8-9 months to detect high hyperopia. Those randomized to spectacle treatment had better acuities and stereopsis than age / community matched children when they reached age 6 years.  
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Sean Donahue reviewed anisometropic children detected from community MTI photoscreens of over 119,000 children in Tennessee. For each year younger screened, the proportion and severity of amblyopia decreased. In his AAPOS talk, Donahue noted that the profound age-dependence was greatest for increasing anisometropia over 1 diopters.

Teed RG, Bui CM, Morrison DG, et al. Amblyopia therapy in children identified by photoscreening. Ophthalmology;117(1):159-62.2010.

ABCD Results Video presented at AAPOS by Valerie Kirk
Valerie Kirk and Michelle Clausen reported the ABCD experience fromthe 6% positive referrals with 82% PPV from over 21,000 lay screenings under age 4 years who were followed at least two years and after age 6. Infants and toddlers (n=36) had better average acuity (0.17 logMAR) patched HOTV than did those screened at nursery-age (n=54, 0.26 logMAR) (Archives of Ophthalmology 2008)  
Stiff H, Dimenstein N, Larson SA. Vision screening outcomes in children less than 3 years of age compared with children 3 years and older. J AAPOS. 2020;24(5):293  
ABCD concludes that early objective screening with consistent spectacle therapy can result in better amblyopia outcomes and therefore should be actively supported and Funded wherever technology is available.  


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