What are the recommended screening guidelines for amblyopia in preschool-aged children in the UK?

Recommended screening guidelines for amblyopia in preschool-aged children in the United Kingdom:

• Children with suspected or confirmed squint (strabismus), which is a common cause of amblyopia, should be referred to the local paediatric eye service for assessment and treatment. Early referral is important to prevent or stop amblyopia from worsening.
• Orthoptic vision screening is recommended as part of developmental surveillance, especially for children born preterm, to detect amblyopia early.
• Management of amblyopia includes occlusion therapy (patching the normal eye to encourage use of the amblyopic eye), which is usually effective and typically part-time, with duration depending on the child's age and severity of amblyopia.
• Penalisation therapy using atropine drops may be used when compliance with occlusion therapy is problematic.
• Primary care professionals should encourage compliance with treatment plans, including occlusion therapy, and continue prescriptions for atropine drops under shared care agreements if required.
• Any child with new-onset squint or signs suggestive of amblyopia should be referred urgently if red flags such as double vision, headaches, or nystagmus are present; otherwise, routine referral is appropriate.

These recommendations align with the National Screening Committee’s advice and NICE guidance on squint and amblyopia management in children, emphasizing early detection and treatment to optimize visual outcomes ⁴,⁴.