A narrative review has been published that considers photoscreening used in community services, focusing on costs, cost-effectiveness and scope of use, compared with EUSCREEN project Country Reports describing how photo- and automated screening is used internationally.
Evidence that photoscreening reduces amblyopia or strabismus prevalence or improves overall outcomes is weak, as is evidence of cost-effectiveness, compared to later visual acuity screening. Currently, the most cost-effective option seems to be a later, expert VA screening with the opportunity for a re-test before referral.
The full paper can be found here.