of Vision Screening is to detect progressive, serious pediatric
eye disorders, and particularly amblyopia,
in a cost effective manner
and at an early enough time that treatment will be effective. Some
tests work better than others in screening serious pediatric eye
disorders. ABCD recommends age-appropriate
guidelines. ABCD 2021 Favorites.
A pediatrician will refer certain children for a
confirmatory eye examination if
that child has a positive family history of certain conditions,
or if that child has certain medical conditions (Risk
Factors). Parents should be vigilent for Warning
Signs of Pediatric Eye Disorders.
Since amblyopia is a condition characterized by
decreased visual acuity in one or both eyes, sensory
tests of monocular acuity and / or depth
perception can identify patients with amblyopia or other pediatric
eye disorders. Diopsys used a automated
VEP "acuity" test. Eye-N-Joy uses an eye-tracking game. Parents can download a Home
Acuity Test , download a Powerpoint
test, or try the FAST.
Amblyopia is often associated with poor focus (refractive
error), poor alignment and/or disruptions of light getting into
the eye, objective tests of the optics and anatomy of the eyes can
detect risk factors early in (sometimes before) the onset of amblyopia.
Objective tests include direct
observation of reflected light in both pupils (Bruckner
Test) or photoscreening. Other
objective tests include remote autorefraction,
foveal birefringence and visual evoked potential (VEP). Infants
should have redreflex test and cover
test. Objective Tests have increased benefit very EARLY,
in Infants and toddlers. Instrument Screeners Compared
The results or interpretations of vision screen
tests modifies the need for, and ugency of, confirmatory
With insurance utilization of CPT code 99174 or 99177, pediatric practices should choose a photoscreener.