Preschool vision screening: a recent report calls for a halt

Abstract

Purchasers are advised against implementing preschool vision screening programmes and providers should consider discontinuing them. This is the clearly stated recommendation of a recent report by the NHS Centre for Reviews and Dissemination (NHS CRD).1 The role of this organisation is to promote best practice by disseminating its findings to key decision makers in the NHS and to consumers of healthcare services. Hence, calls to consider and implement the report’s findings are likely to be swift. The report was prepared by the Health Services Research Unit at Oxford University backed up by an advisory group which included representatives from all the ophthalmic professions. The bulk of the report is given over to a systematic review of research on the effectiveness of preschool vision screening (PSVS). An additional remit was to provide evidence on which decisions about future provisions of service can be based, and to highlight areas where future research is required. The review was restricted to studies involving the target conditions of amblyopia, refractive error, and non-cosmetically obvious squint (NCOS). In addition to hand searching, 17 electronic databases were consulted initially flagging over 5000 references. More than 500 abstracts were scrutinised and 85 publications included in the main analysis. Research questions of relevance to the objectives were posed under the headings of prevalence, natural history, disability, treatment, and screening. No studies were identified whose primary aim was to establish the prevalence of the target conditions. Prevalence estimates ranging from 2.4 to 6.1% (all target condition combined) were sourced from retrospective analyses of hospital records and from observational studies of the yield …