We welcome the article on BBC Wales recently raising awareness of amblyopia, but were concerned at the characterisation of child vision screening services within the piece.
The recent article on BBC Wales reported on a seven-year-old boy who had been diagnosed with amblyopia following a visit to an optician. The report was also aired on BBC Wales Today.
While we welcome the call for children to get their eyes tested regularly, we were concerned at the characterisation of child vision screening services. Vision screening of reception-aged children is a highly cost-effective way to screen for amblyopia, a condition causing reduced vision in one or both eyes. The orthoptic-led service in Wales, which has been mandatory for ten years, is carried out by the school nursing team with training provided by an orthoptist. As this takes place in schools, it ensures as universal a service as possible, screening children who may be significantly less likely or able to attend an appointment at an opticians. This is the approach recommended by the UK National Screening Committee.
While the article is correct to highlight that screening is not the same as a sight test, this is not the intention of the service. It is a screening service specifically targeting amblyopia. Where low vision in one or both eyes is identified, the child will be referred to an opticians or a hospital eye service for further assessment. It is therefore potentially quite misleading to suggest that these tests might not be being carried out correctly.
We also felt that there were some inaccuracies in the characterisation of amblyopia in the article, including the suggestion that the condition can cause ‘squinting’, headaches and strabismus. This is incorrect, and the need for screening for the condition is due to the fact that, as it usually affects one eye, there are no signs or symptoms present. Furthermore, while treatments are more likely to be effective in younger children, under 8 years of age, treatments, such as occlusion therapy or patching, can still be effective in older children.
