Amblyopia screening: the current state and opportunities for optimization.

Introduction: Amblyopia, the leading cause of monocular childhood vision loss, affects millions and is projected to increase. Early detection and treatment are crucial for preventing vision impairment.

Areas covered: This commentary reviews the current state and opportunities for improvement in amblyopia screening strategy and technology focused primarily within the United States. A review of current guidelines from organizations and a literature review of innovations between 1999 and 2024 informed this commentary. Organizations recommend routine vision screening for children, starting in infancy and continuing through adolescence. However, the variations in screening devices, components, timelines, and requirements leave room for improving outcomes. An exploration of instrument-based screening which has emerged as an alternative to traditional optotype testing will be investigated, and the risks of these instruments with high sensitivity and varying specificity will be acknowledged. Finally, new approaches to directly identify amblyopia and search for innovative biomarkers that indicate amblyopia risk or amblyopia itself will be discussed.

Expert opinion: Improving the treatment of amblyopia necessitates the reimagination of current practices in connecting patients to care. Technologies that incorporate novel diagnostic approaches, like the consideration of specific biomarkers or the use of artificial intelligence, hold promise to identify cases of amblyopia rather than its risk factors.