Your recent article, “NIH Study on Kids’ Vision Screenings Draws Mixed Response” in the Aug. 1 issue, highlights the ongoing debate between vision screening and comprehensive eye exams. As chairman of the Pediatric Vision Advisory Committee of Prevent Blindness America (PBA), I suggest this debate is a misplaced one. These procedures, both key to the effective continuum of comprehensive eye care, serve different purposes and thus cannot be compared.

PBA heartily endorses the American Optometric Association’s commitment to “ensuring that no child is left behind due to vision problems.” Further, we acknowledge that comprehensive eye exams are the “Gold Standard” to eye care. Vision screenings are admittedly a “safety net” initiative, albeit a necessary one. America’s public health system requires such an approach to health care. Similar “safety net” screenings have been enormously effective in the detection of diabetes and hearing problems. The purpose of vision screening is to increase the number of children in need of care who receive comprehensive eye exams, not the alternative. In 2004, PBA screened more than 2.2 million children, referring almost 200,000 for comprehensive eyecare. Many of these children would have otherwise gone unserved.

PBA’s screening protocols are developed and regularly reviewed by its Pediatric Committee, which consists of leading optometrists, ophthalmologists and PhD’s from across the country. As one of the nation’s leading vision screening organizations, a critical component of a PBA screening is the referral for a comprehensive exam upon the suspicion of any potential eye problem. Further, it is always pointed out that a screening is not a comprehensive exam and should not be seen as replacing one.

The recent National Eye Institute (NEI) findings clearly support that vision screening is effective when properly performed. It is time to end the needless debate between vision screening and comprehensive eye exams and refocus our collective commitment to the health of the nation’s children.

Joseph M. Miller, MD, PhD
Chair, Pediatric Vision Advisory Committee
Prevent Blindness America

Dr. Miller also serves as Professor and Head of Ophthalmology and VisionScience at the University of Arizona.