A review of primary care vision screening

Preschool vision screening (PVS) is an essential component of detecting treatable vision loss in young children. Many state screening programs are struggling to cope with unfunded mandates. Neither school nor community screenings are standardized, and often result in both under- and over-referrals.

Compared to hearing and dental screenings, PVS is not being performed in the primary care office. Why is this, and what could be done to change the situation?

To be effective, PVS relies on the participation of the primary care office that already has a rapport with the child and a relationship with the child's family within the medical home. Vision screening can be included as part of wellness testing strategies.

The current state of PVS as evidenced by the literature points to a lack of education and training in the primary care arena. Orthoptists are ideally trained to perform accurate PVS and to emphasize its importance. Because of time constraints however, they might be better utilized as a teaching liaison between ophthalmology and pediatric / family practice training programs.