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Alaska Blind Child Discovery

A cooperative, charitable research project to vision screen every preschool Alaskan

Reasons for Vision Screening

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.
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: 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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