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AOA ‘Disappointed, Concerned’ by New Screening Recommendations


They’re ‘potentially a stumbling block.’

 The American Optometric Association announced that it is “disappointed” and “concerned” about new recommendations by the U.S. Preventive Services Task Force for children’s vision screening for amblyopia.

The recommendations “do not effectively address vision problems among the nation’s children and are potentially a stumbling block to them getting the care they need,” AOA stated on its website.

The task force recommendations were published in the Journal of the American Medical Association under the title “Vision Screening in Children Ages 6 Months to 5 Years: A Systematic Review for the U.S. Preventive Services Task Force.”

AOA wrote that the task force’s recommendations reflect no changes since its last update in 2011, “despite two landmark reports this year by experts on children’s eye health and vision care.” The reports are:

  • The National Academies of Sciences, Engineering and Medicine (NASEM)’s “Making Eye Health a Population Health Imperative: Vision for Tomorrow,” which confirmed that undiagnosed and uncorrected eye and vision problems in children are a significant public health concern.
  • The AOA’s Evidence-Based Clinical Practice Guideline: Comprehensive Pediatric Eye and Vision Examination, which stresses the need for comprehensive eye exams for children over less rigorous screenings. The guideline was recently recognized with acceptance to the National Guideline Clearinghouse.”In fact, the new recommendation reiterating ‘no change’ appears to overlook the NASEM report, which underscored that avoidable vision impairment occurs because of outdated assumptions, missed opportunities and shortfalls in public health policy and health care delivery,'” Quinn said. “Promoting optimal conditions for vision and health requires changes to our current system of vision health prevention.”
  • In March, the AOA wrote the chairperson of the USPSTF, Dr. Kirsten Bibbins-Domingo, objecting to the recommendations during a public comment period. The AOA recommended the task force consider:
  • “Doctors of optometry are extremely concerned that the USPSTF recommendations will continue to hamper ongoing efforts to combat unacceptably high rates of preventable and treatable vision loss in children-especially among vulnerable and at-risk children who deserve care in communities across America,” said Dr. Christopher J. Quinn, president of AOA.
  • Being as specific as possible as to the type and purpose of the screening that is being performed: screening for amblyopia.
  • Providing clarity on the role of screening in the vision care system for children.
  • Giving further consideration and elucidation of the possible harms of “false negatives,” as well as “false positives” of screening.
  • Providing greater clarity about the population for whom amblyopia screening is appropriate.
  • The AOA stated on its website that its recommendations “are not reflected in the new task force recommendations.”

“By focusing on the effectiveness of screenings to detect only one of the most serious visual problems — amblyopia — the task force ignores the multitude of vision problems in children that screenings have repeatedly demonstrated are not adequately detected,” Quinn said.


ARTICLE BY: INVISION Staff 07 September 2017