US Preventive Services Task Force Vision Screening Recommendations

Abstract

We commend the recent recommendation by the US Preventative Services Task Force (USPSTF) for vision screening of all children at least once between the ages of 3 and 5 years.1 Amblyopia is the leading cause of monocular visual impairment in US children. Several high-quality, randomized controlled clinical studies have shown that amblyopia treatment is highly successful.2 Early detection is critical, because there is a window for successful treatment. Hence, this recommendation is an important step toward the elimination of a major preventable cause of lifelong visual loss. The USPSTF recommendation is consistent with the American Academy of Pediatrics “Recommendations for Preventive Pediatric Health Care,”3 and Bright Futures Guidelines for Health Supervision of Infants Children and Adolescents ,4 both of which recommend universal screening for vision at the 3-, 4-, and 5-year health supervision visits. Although we support the task force recommendation to provide vision screening for children aged 3 to 5 years, we are concerned about the finding of “insufficient evidence” (I) for screening children under the age of 3. Figure 1 in the recommendation1 notes that current practice for these younger children is “assessment … Address correspondence to Sean P. Donahue, MD, PhD, Departments of Pediatrics, Ophthalmology, and Neurology, Vanderbilt University Medical Center/Vanderbilt Eye Institute, 2311 Pierce Ave, Nashville, TN 37232-8808. E-mail: sean.donahue{at}vanderbilt.edu