[The practice guideline 'Refraction errors' from the Dutch College of General Practitioners: response from the...

The practice guideline 'Refraction errors' from the Dutch College of General Practitioners provides a guideline for referral of persons aged 6 to 65 with gradual loss of vision to either an optician or an ophthalmologist. In this guideline, relevant questions regarding important symptoms are missing, and the value of the proposed examination employing 'diagnostic refraction' has insufficient scientific support. In addition, the possibility to send children between 6 and 10 years of age to the optician may be dangerous for some of the patients, and there are no explicit indications for the urgency of referral to the ophthalmologist. Due to these short-comings, the guideline may fail to provide optimal preventive and therapeutic eye care for the target group of patients concerned.