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Response to the BBC feature on Children’s Eye Testing/Vision Screening

28 August 2018

In response to the BBC features on Children’s Eye Testing/Vision Screening 22 August 2018

In October 2017, Public Health England released new guidance for local authorities (LA) to support vision screening testing for all children aged 4-5 years (https://www.gov.uk/government/news/new-guidance-to-improve-vision-screening-for-young-children). The supporting documents, available online, include parent information leaflets, with a link to the NHS choices web pages on childhood vision testing (https://www.nhs.uk/conditions/eye-tests-in-children/). These resources were developed by a multi-disciplinary group, including representatives from the College of Optometrists, the British & Irish Orthoptic Society, and The Royal College of Ophthalmologists.

In practice for most children, this means that their vision should be tested in school in their first year. If this is not happening, parents should be encouraged to ask why this is not taking place. Making sure that local authorities provide this service for ALL children is particularly important for those children whose parents are unable to visit an opticians specially for this test. The cost of the test is covered because the NHS pays opticians for each test they do. It is only the test that is ‘free’ for the family, who still face time, travel and other financial costs in getting their child to the optician.

The Association of Optometrists, in its recent press release, continues to recommend that children ‘have their first sight test around the age of three’. Since the practice was discontinued within the NHS, based on the findings of the UK National Screening Committee (NSC) commissioned review of published evidence, the rationale for advocating this should be scrutinised.

The NSC’s widely accepted recommendation is that vision testing takes place at age 4-5 years to achieve the best outcome from whole population testing.  Any suggestion that parents should use sight tests conducted by opticians as an alternative to the NSC programme of child vision screening at 4-5 years is a direct challenge to the NSC evidence based universal childhood screening.

Additionally, the BBC Breakfast article (Child sight ‘risked by eye test delays’ https://www.bbc.com/news/uk-politics-45258771, Jane Thompson’s story) appeared to wrongly suggest that optometrists are able to decide when patching is needed for amblyopia and, more worryingly, that ophthalmic professionals cannot treat amblyopia in children aged 7 years or older. The message should be that intervening at age 4-5 years is best, but older children can still benefit from treatment. This factually incorrect evidence may dissuade families from seeking medical attention.

The Royal College of Ophthalmologists
Paediatrics Sub-Committee

The British & Irish Orthoptic Society (BIOS) has also issued a response to the AOP press release and BBC feature

https://www.orthoptics.org.uk/the-british-and-irish-orthoptic-society-response-to-the-article-concerning-vision-tests-for-children/  

About Public Health England’s National Screening Committee  https://www.gov.uk/government/publications/child-vision-screening