At what ages should most parents start screening for amblyopia, and what signs trigger referral?

• A. Screening begins around birth; referral for red reflex abnormalities.
• B. Screening around ages 3–5; referral for decreased visual acuity, asymmetry, strabismus, or persistent eye misalignment.
• C. Screening at ages 8–10; referral for color vision defects.
• D. Screening at 6 months; referral for tearing.

Answer: (B)

Amblyopia screening is most effective when done in the preschool years, around 3 to 5 years old, because children at this age can participate in standard vision tests and the condition is most treatable if caught before formal school years. If the screening reveals decreased visual acuity in one eye, a noticeable difference in vision between the two eyes, or evidence of strabismus or persistent misalignment, these are red flags that warrant referral to an eye specialist for a full evaluation and possible treatment.

Screening at birth or 6 months focuses on detecting other eye issues, like red reflex abnormalities or tearing, which are not the typical triggers for amblyopia referral. Color vision testing around later childhood is not the main method for amblyopia screening either.