Pediatric Eye Screening: Current Standards and Gaps in Care

Abstract

The nonmydriatic, noncontact, and rapid acquisition features of ultra-widefield fundus (UWF) imaging create an invaluable tool for pediatric retinal screening in primary care. This review assesses the landscape of pediatric eye screening, identifies gaps in diagnosing a range of pediatric retinal conditions, and discusses potential uses of UWF imaging for retinal screening. The standards for pediatric eye screening in primary care include red reflex testing, direct ophthalmoscopy, external ocular exam, instrument-based screening, and visual acuity testing. These tests fail to diagnose several treatable retinal diseases. In this gap, UWF retinal imaging provides a panoramic view of the retinal landscape, allowing for a more comprehensive examination. For several pediatric retinal conditions (eg, retinal detachment, retinopathy of prematurity, Coats’ disease, familial exudative vitreoretinopathy, Stargardt disease, ocular toxocariasis), UWF retinal imaging provides the high spatial resolution necessary for reliable diagnosis, expediting time to treatment while maintaining low false positive rates.