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Academy urges caution on pediatric eye exam study
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SAN FRANCISCO — Health care professionals should view with caution a recent study touting the cost-effectiveness of giving eye exams to preschool-age children, the American Academy of Ophthalmology said in a press release. AAO said more research on the subject is needed.
According to AAO, “Eye Exams for Children: Their Impact and Cost Effectiveness” makes several unproven assumptions, including that giving preschool children eye exams “would detect, treat and cure significantly more cases of amblyopia than vision screenings.” The study also stated that universal eye exams would be “highly cost-effective” and would produce “a greater return on investment than many other common medical interventions,” according to a press release on the study.
The study, sponsored by the Vision Council of America (VCA), said that universal eye exams would greatly outperform a theoretical system in which every child received a vision screening. That, in turn, would lead to 33,000 more children being diagnosed with amblyopia, according to the study.
“Providing eye exams alone does not treat or cure eye disease as the study’s executive summary states,” said George Beauchamp, MD, in the AAO release. “The study also does not prove exams would be highly cost-effective and produce a greater return on investment than many common health interventions, as it claims.”
AAO took issue with the study’s methods as well, stating the data used in the study “mixes well-conducted clinical trials and weak, poorly conducted and noncontrolled studies,” said Sean Donahue, MD, PhD, in the press release.
Dr. Donahue said the study is silent on the “costs” of an eye exam mandate. He recently estimated a nationwide mandatory preschool vision exam program could cost more than $200 million annually.
Dr. Beauchamp noted the VCA study results conflict with recent recommendations from the U.S. Preventive Services Task Force, which announced earlier this year its support of vision screening for children under the age of 5 years. The Task Force found vision screening tests “have reasonable accuracy in identifying strabismus, amblyopia and refractive errors in children,” AAO said.
The VCA study acknowledged that “little data has been published on the relative performance of comprehensive exams and vision screenings, the costs and outcomes associated with treating amblyopia, or the impact of untreated amblyopia on quality of life.” The study said there is a “clear need for further research on amblyopia and other visual disorders.”
“Vision screening serves more children for less cost and is highly effective in picking up vision loss in younger children,” AAO stated in its release. “Mandating complete eye exams for all preschool children is medically unnecessary and wasteful of limited resources.”