The Brazilian experience on screening, visual assessment, and prescription of glasses in childhood: A perspective of global interest

AJO International Pub Date : 2025-07-22 DOI:10.1016/j.ajoint.2025.100158

ACSB Carneiro , JM Furtado , AL Silva , ALF Darcie , AC Ribeiro , LM Hopker , C Nakanami , SP Donahue , JD Rossetto

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Abstract

Purpose

This perspective presents evidence-based guidelines developed by a representative expert group from Brazil. The guidelines aim to enhance pediatric eye care through structured screening protocols, comprehensive eye examinations, and effective eyeglass prescriptions tailored to local contexts.

Methods

The guidelines were developed through a narrative literature review and expert consensus among Brazilian Society of Pediatric Ophthalmology members, utilizing a comprehensive search strategy on PubMed from September 2022 to July 2024.

Results

Key recommendations include performing the red reflex test (RRT) before neonatal discharge and repeating it at least three times per year during the first three years of life. Additional recommendations include initiating photoscreening at one year of age and conducting visual acuity screening between ages 3 and 5—prioritizing age 5 for amblyopia detection—and again at ages 10–11. Follow-up screenings are advised at critical developmental stages. To expand access, trained non-ophthalmology professionals should participate in screening efforts within existing healthcare frameworks. Scaling secondary and tertiary care and aligning the program with other governmental initiatives are essential for sustainability and impact. Additionally, structuring the health program to align with other government initiatives will help ensure its sustainability and long-term impact.

Conclusion

These guidelines provide a solid foundation for effective pediatric eye health programs, contributing to broader public health and sustainable development goals.

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巴西在儿童筛查、视力评估和配戴眼镜方面的经验：全球关注的视角

目的本视角介绍了巴西一个代表性专家组制定的循证指南。该指南旨在通过结构化的筛查方案、全面的眼科检查和适合当地情况的有效的眼镜处方来加强儿童眼科保健。方法通过叙述性文献综述和巴西儿科眼科学会成员的专家共识，利用2022年9月至2024年7月在PubMed上的综合搜索策略，制定了该指南。主要建议包括在新生儿出院前进行红色反射测试（RRT），并在生命的前三年每年至少重复三次。其他建议包括在1岁时开始进行光筛查，并在3至5岁之间进行视力筛查——优先在5岁时进行弱视检测——并在10-11岁时再次进行。建议在关键发育阶段进行后续筛查。为了扩大获得机会，训练有素的非眼科专业人员应参与现有医疗保健框架内的筛查工作。扩大二级和三级保健的规模，并使该计划与其他政府举措保持一致，对可持续性和影响至关重要。此外，构建与其他政府举措相一致的卫生计划将有助于确保其可持续性和长期影响。结论本指南为有效开展儿童眼保健项目提供了坚实的基础，有助于实现更广泛的公共卫生和可持续发展目标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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AJO International

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