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Cohort studymedRxiv : the preprint server for health sciences · 2026

Adherence to Red Reflex and Vision Screening Recommendations: A Deep Dive into Primary Care Implementation Gaps.

Afua O Asare, Giovani Robles, E Eugenie Hartmann … J D Smith

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OphthalmologyCohort study

Only 21.1% of pediatric visits included a red reflex eye exam

Adherence to Red Reflex and Vision Screening Recommendations: A Deep Dive into Primary Care Implementation Gaps.

Afua O Asare … J D Smith

medRxiv : the preprint server for health sciences · 2026

Background

Early childhood vision screening is critical for detecting amblyopia and other vision-threatening conditions.

Methods

We conducted a retrospective review of electronic health records for children 3-5 years attending well-child visits in 2022 in one of three representative primary care clinics within a university health system.

n = 212

21.1%

Results

21.1%

fewer than 1 in 5 pediatric visits included this eye disease screening check

n = 212

More results

Females had higher odds of red reflex assessment (aOR 1.53).

Other/Multiracial children had lower odds of red reflex assessment than Non-Hispanic White children (aOR 0.48).

Screening rates varied significantly by clinic site.

“

Conclusion · 1 of 2

Visual function and red reflex assessment are inconsistently performed in pediatric primary care, with particularly low rates of red reflex documentation. Screening rates varied between clinics and were affected by age.

Conclusion · 2 of 2

These findings highlight missed opportunities for early detection of vision-threatening conditions and identify targets for improving adherence to pediatric vision screening recommendations.

Post

Adherence to Red Reflex and Vision Screening Recommendations: A Deep Dive into Primary Care Implementation Gaps.

Only 21.1% of pediatric visits included a red reflex eye exam

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