BMJ 1997;315:1247-1248 (15 November)
Editorials
The future of preschool vision screening services in Britain
We need better research on which to base policy decisions
What should be done in Britain about existing and proposed programmes to screen
preschool
children for the related conditions of amblyopia, refractive error, and strabismus? Those who
have
visited this debate before may not be surprised that the recently published systematic review on
preschool vision screening from the NHS Centre for Reviews and Dissemination identified
serious
deficiencies in the research evidence which informs current policy.1 However, the conclusions that "Providers currently offering
screening programmes should consider discontinuing them" and, "From an ethical
point of view, it is appropriate to continue to screen only in the context of a controlled trial of
treatment" will undoubtedly prove more controversial.
The available research evidence has been interpreted differently in similar reviews from
North America,2 3where
it has been concluded that preschool vision screening should continue. Why have reviewers
reached
different conclusions from essentially the same data? By integrating existing information in an
unbiased . . . [Full text of this article]

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