What is the most effective way to identify children with vision problems?  The American Optometric Association and the American Public Health Association support comprehensive vision examinations for all children.  The American Academy of Ophthalmology and the American Academy of Pediatrics favor vision screenings.  The latter organizations use an economic argument in support of vision screenings.  It is far less expensive to perform a vision screening vs. comprehensive vision examinations on the entire 1st grade of your local elementary school……… or is it?

The economic view of this debate considers only direct costs.  In the same amount of time it takes to examine a 6 year old child, a vision screening could be performed on 4 or 5 children.  If the screening is performed during the child’s annual visit to the pediatrician, then the cost of an “unnecessary” vision examination is eliminated.  Manpower and equipment costs are easily calculated.  Using this approach, vision screenings are less expensive.  But this type of economic analysis does not consider the INDIRECT costs.  Vision screenings fail to identify many children with vision disorders.  How do you calculate the cost of an undiagnosed vision problem on the quality of life of a school-aged child?

If every child is going to be given the opportunity to learn, then every child must have a comprehensive vision examination when they enter school. The emphasis must be on maximizing our resources, and not on minimizing the need because it translates to a lower price tag.

For more information about the limitations of vision screenings, see Volume 14, Issue 5, article by Zaba et al in the Journal of Behavioral Optometry, 2003.

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