Future of preschool vision screening

BMJ 1998;316:937 ( 21 March )

Letters

Future of preschool vision screening

Conclusions for or against services are invalid without appropriate research evidence

Cost effectiveness of screening for amblyopia is a public health issue

Review article did not separate review and implementation processes

The existence of a service is not evidence of its value

Authors' reply

Conclusions for or against services are invalid without appropriate research evidence

The first 150 words of the full text of this article appear below.

EDITOR $---$ Rahi and Dezateux highlighted the current dilemma about preschool vision screening.¹ A systematic review has detailedthe lack of published evidence on whether the target conditions(amblyopia, non-obvious squint, and refractive error) are disablingand whether detection at preschool age results in better treatmentoutcomes than detection at school age.²

The review concludes that published hard evidence is lacking on preschool vision screening but then recommends that providersconsider discontinuing current programmes. Without appropriatehigh quality research evidence, conclusions either in favour ofor against these services are equally invalid. Ongoing researchinto this subject has occurred within a multidisciplinary birthcohort study of 14 000 children born in Avon between April 1991and December 1992.³ A randomised controlled trial of screeningmethods for ocular defects in children under 3 years of age hascollected data on whether any disability in social, physical,or cognitive function is associated with the . . . [Full text of this article]