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AOA concerned with task force recommendations on children’s vision screening
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The American Optometric Association announced that it is “extremely concerned that the U.S. Preventive Services Task Force Children’s Vision Screening Recommendations will hamper ongoing efforts to combat unacceptably high rates of preventable vision loss in children,” AOA President Joe E. Ellis, OD, said in an AOA press release.
According to a recent update of the 2004 U.S. Preventive Services Task Force, “The USPSTF now recommends vision screening for the presence of amblyopia and its risk factors for all children 3 to 5 years of age. For children younger than 3 years, the USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of vision screening.”
The recommendations “disregard the vision and eye health needs of America’s children under the age of 3 – the most critical stage of visual development – apparently ‘due to the child’s inability to cooperate,’” the AOA said in its press release.
The USPSTF statement reads: “Typical components of vision screening include assessments of visual acuity, strabismus and stereoacuity. Younger children often are unable to cooperate with some of the screening tests performed in clinical practice, such as visual acuity testing. Stereoacuity testing often is omitted and may be performed incorrectly when attempted. Screening of younger children may be difficult and often yields false-positive results because of the child’s inability to cooperate with testing.”
The AOA responded to this, saying, “Despite this misconception, optometrists and pediatric ophthalmologists alike are well trained and have access to specialized equipment and procedures that enable comprehensive and cooperative evaluation of children’s vision and eye health at less than 3 years of age.”
The USPSTF guidelines recommend that clinicians, when deciding to refer children younger than 3 years for screening, should consider that “most studies show that screening and treatment later in the preschool years seem to be as effective at preventing amblyopia as screening and treatment earlier in life.”
AOA President-Elect Dori Carlson, OD, disagreed. “These ill-advised USPSTF recommendations seem to ignore mountains of scientific data showing that the vast majority of vision screenings for children demonstrate an unacceptably high rate of error,” she said in the AOA press release.
Prevent Blindness America (PBA) also responded to the task force’s recommendations. “Although there are some concerns with these recommendations from vision health groups, PBA is pleased that the standards for vision screening for the 3- to 5-year-old age group have not been lowered,” the group said in a statement.
“A professional eye examination is, without a doubt, the gold standard of eye care and should always be encouraged,” PBA President and Chief Executive Officer Hugh R. Parry said in the PBA press release. “Yet vision screenings are an essential element of a strong public health approach to children’s vision care, facilitating the early identification of eye problems and linkage to appropriate care.”
The USPSTF website states that the group is an independent, voluntary body that is supported by the Agency for Healthcare Research and Quality. According to the task force member listing on the USPSTF website, it appears that no optometrists served on the task force, but Primary Care Optometry News was unable to confirm this with the USPS.
According to the AOA press release, the recommendations were updated “without adequately consulting with optometrists.” – Nancy Hemphill, ELS
The USPSTF guidelines can be found at http://www.uspreventiveservicestaskforce.org/uspstf11/vischildren/vischildrs.htm.