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Alaska Blind Child Discovery
A cooperative, charitable research project to vision screen every preschool Alaskan
 

Reasons for Vision Screening

  
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 The World Health Organization promotes a ten-point criteria list as to whether screening is warranted for certain diseases[1]. Pediatric Vision Screening appears to fit WHO criteria because amblyopia 1) is an important health problem[2], 2) there are accepted forms of treatment[3], 3) in the developed world there are facilities for diagnosis and treatment, 4) there appears to be a latent and symptomatic stage[4], 5) there are suitable vision screening tests[5], 6) vision screening is acceptable to most parents and communities[6], 7) the natural history of amblyopia is fairly well understood[7], 8) most pediatric ophthalmologists agree on whom to treat[8,9], 9) vision screening appears to be cost effective[10-12] and 10) detection of cases of amblyopia can be a continuous process[13].
In selected communities in Europe[14,15] and Israel[16], careful pre-school vision screening combined with thorough amblyopia treatment resulted in substantially less residual amblyopia vision impairment than comparable communities lacking that vision screening.
REFERENCES:
1. Wilson J, Junger G. Principles and practice of screening for disease. Public Health paper No. 34. Geneva: World Health Organization; 1968.
2. Beauchamp G, Bane M, Stager D, Berry P, Wright W. A value analysis model applied to the management of amblyopia. Tr Am Ophth Soc. 1999;97:349-372.
3. PEDIG. A randomized trial of atropine vs. patching for treatment of moderate amblyopia in children. Arch Ophthalmol. 2002;120(3):268-278.
4. Simons K. Amblyopia characterization, treatment and prophylaxis. Surv Ophthalmol. 2005;50(2):123-166.
5. VIPS. Comparison of preschool vision screening tests as administered by licensed eye care professionals in the vision in preschoolers study. Ophthalmology. Apr 2004;111(4):637-650.
6. Arnold RW, Gionet E, Jastrzebski A, Kovtoun T, Armitage M, Coon L. The Alaska Blind Child Discovery project: Rationale, Methods and Results of 4000 screenings. Alaska Med. 2000;42:58-72.
7. Simons K, Preslan M. Natural history of amblyopia untreated owing to lack of compliance. Br J Ophthalmol. 1999;83(5):582-587.
8. Miller JM, Harvey EM. Spectacle prescribing recommendations of AAPOS members. J Pediatr Ophthalmol Strabismus. Jan-Feb 1998;35(1):51-52.
9. Beck RW. Clinical research in pediatric ophthalmology: The Pediatric Eye Disease Investigator Group. Curr Opin Ophthalmol. 2002;13:337-340.
10. Miller JM. Cost-effective vision screening for astigmatism in Native American preschool children. Ophthalmol Vis Sci. 2003;44:56-63.
11. White A. Costs and Benefits of Comprehensive Eye Exams. Abt Associates. Available at: http://www.abtassociates.com/Page.cfm?PageID=12301&OWID=2109767275&CSB=1. Accessed 6/13/05, 2004.
12. Arnold RW, Armitage MD, Gionet EG, et al. The cost and yield of photoscreening: Impact of photoscreening on overall pediatric ophthalmic costs. JPOS. 2005;42(2):103-111.
13. Swanson J. Eye examination in infants, children and young adults by pediatricians: AAP Policy Statement. Ophthalmology. 2003;110(4):860-865.
14. Kvarnstrom G, Jakobsson P, Lennerstrand G. Screening for visual and ocular disorders in children, evaluation of the system in Sweden. Acta Paediatr. 1998;87(11):1173-1179.
15. Williams C, Northstone K, Harrad R, Sparrow JM, Harvey I, ALSPAC-Study-Team. Amblyopia treatment outcomes after preschool screening v school entry screening: observational data from a prospective cohort study. Br J Ophthalmol. 2003;87(8):988-993.
16. Eibschitz-Tsimhoni M, Friedman T, Naor J, Eibschitz N, Friedman Z. Early screening for amblyogenic risk factors lowers the prevalence and severity of amblyopia. J AAPOS. 2000;4(4):194-199.		  
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