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Guidelines aside, children of all ages need eye care
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 Michael D. DePaolis |
Merriam-Webster defines a task force as “a temporary grouping under one leader for the purpose of accomplishing a definite objective.” While the definition does not specifically state such, it is generally assumed the “grouping” is a diverse representation of individuals with expertise in the subject of concern. Even so, task forces are not infallible and can occasionally make recommendations that are contentious and – on the surface – seem illogical.
Vision screening guidelines
Recently, the United States Preventive Services Task Force (USPSTF) updated its recommendations for vision screening in children. They concluded that vision screening for the presence of amblyopia and its risk factors is indicated for children between 3 and 5 years of age. While everyone agrees this is a prudent recommendation, what about those younger than 3 years? The USPSTF states “current evidence is insufficient to assess the balance of benefits and harms of vision screenings” in this younger age group. Furthermore, the report asserts “younger children often are unable to cooperate with some of the screening tests performed in clinical practice ...”
On the surface, it appears the USPSTF’s recommendations are based on the assumption that all eye screenings require subjective responses, and children under age 3 are simply too young to cooperate. Does this mean children younger than 3 do not need to be seen? Or, is it really just an assertion that vision screening in those under age 3 is not a particularly revealing or cost effective exercise?
If one assumes all vision screenings – those for infants and school-age children alike – are the same, then it is easy to see how the USPSTF has reached its conclusion. After all, we do not expect toddlers to do very well with Snellen acuity, Randot stereoacuity or phoria testing. However, given the various objective techniques we have for examining this demographic, it is hardly fair to categorize them as an uncooperative group unworthy of evaluation. In addition, I think we would all agree that when it comes to amblyopia, earlier intervention is better.
Where to go from here
So, given the USPSTF’s guidelines, where do we go from here? I recommend we continue doing what we have always done: educate new parents regarding the importance of eye care during early development, work with pediatricians by providing comprehensive eye services support for their patients and, perhaps most importantly, actively participate in InfantSee. InfantSee remains the most comprehensive outreach program available for infants, providing more than just vision screening for those up to 1 year of age. In this respect, InfantSee is arguably the perfect complement to the USPSTF guidelines.
While the debate over the USPSTF recommendations for vision evaluations in children will undoubtedly rage on, one thing remains essential. We must collectively see to it that all children receive the eye care they need.