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RCOphth strongly recommends orthoptist led UK National Screening programme for children

15 September 2016

The Royal College of Ophthalmologists strongly recommends that the orthoptist led UK National Screening programme for children is implemented across all local authorities

The UK National Screening Committee (NSC) has recommended orthoptist led screening for visual impairment in all children aged 4 – 5 years.

From October 2015, responsibility for the funding of vision screening of 4-5 year olds was passed from NHS CCGs to Local Authorities.  However some Local Authorities fail to commission this vision screening, or are even decommissioning screening, because of budgetary pressures.  This shows lack of awareness of the NSC guidance and results in failure to provide a quality assured care pathway for those children with visual impairment or ocular disease who would have been picked up by the vision screening.

If appropriately instigated, the NSC approved service offers an evidence-based, comprehensive, economically efficient and importantly population-based examination of all children.  It means vulnerable children and those at higher risk of visual impairment will be screened.  This is important for children whose parents may not seek advice and for those children who exhibit little or no symptoms of a visual problem, typically because only one eye is significantly affected, or because the child does not know what they should be able to see.  Childhood visual problems, if left untreated, may lead to irreversible loss of vision which could be prevented with screening.

Some commercial organisations such as Boots and SpecSavers now offer alternative ‘free vision screening’ tools to schools to be used by teachers and school staff.  These ‘screening’ tests are not consistent with NSC guidance and are being offered to various age groups without evidence of benefit.

The RCOphth Paediatric Subcommittee agrees with the British and Irish Orthoptic Society (BIOS) that instigation of a ’piecemeal’ vision screening programme is likely to lead to children not being screened at the appropriate age. This will lead to a failure to detect treatable eye conditions, particularly in certain vulnerable groups, within the ’window of opportunity‘ during which treatment is effective.

Professor Christopher Lloyd, Chair of the RCOphth Paediatric Subcommittee said, ‘We strongly believe that children of reception age should be screened using a robust methodology in line with national guidance and only via a compliant and fully audited service as recommended by the National Screening Committee’. 

Local Authorities are asked to review their child vision screening services where non-compliance with the NSC guidance is in place.