The negative impact of amblyopia from a population perspective: untreated amblyopia almost doubles the lifetime risk of bilateral visual impairment

Ten years ago, a systematic review on the effectiveness of preschool vision screening for amblyopia and related target conditions was published in the UK, the Snowdon and Stewart-Brown report.1 After summarising the scientific evidence available at the time, the authors came to the following conclusion: purchasers are advised against implementing preschool vision screening programmes and providers should consider discontinuing them. The response from the paediatric ophthalmology community was, of course, massive, and a lively international discussion ensued. Even though the initial currents in the debate were quite harsh towards the conclusion of the report and even towards the authors, in retrospect we should be very grateful that it was published. In the last few years, we have had the pleasure of reading an impressively large number of well-designed scientific studies, significantly moving forward our knowledge about diagnosis, screening and treatment of amblyopia, as well as challenging some old “truths” (for a recent summary, see Holmes and Clarke2).

However, data on the negative impact of amblyopia from a population perspective have not been as abundant. One of the main problems identified by The Snowdon & Stewart-Brown Report was the lack of evidence showing that …