Evidence-Based CPG on Pediatric Eye/Vision Exam

In preparing for an interview this morning, one of the questions posed to me was the following:  “How do you believe the new AOA ‘Evidence-Based Clinical Practice Guideline: Comprehensive Pediatric Eye and Vision Examination’ will improve patient care and help ODs better manage the care of children?”  Addressing this question of course requires that you be familiar with the new evidence-based CPG.  Frankly despite skimming it I hadn’t appreciated the full magnitude of the new CPG until I went through it, page by page, and would strongly encourage you to do so.

aoa pediatric cpg photo



Here are some powerful takeaway points:

  1. Eye and vision disorders can impose a significant burden on patients, parents, and the public.  The total economic cost of vision loss and eye disorders among children younger than 18 years of age in 2012 was estimated to be $5.9 billion.
  2. The debilitating nature of vision loss results in major indirect and non medical costs including special education services, federal assistance programs, and decrease quality of life.
  3. The above estimate doesn’t include the costs of educational services for children with undiagnosed and untreated vision conditions.  Learning-related vision problems have been reported to be significant contributors to reading difficulties and ultimately to the need for special educations services.  A study of students ages 6-16 with IEPS found high rates of undiagnosed and untreated vision problems affecting reading speed and comprehension.
  4. In addition to current costs, future costs include the loss of a child’s full potential, and limitations on his or her occupational choices and future earnings.  In other words, by overlooking a child’s visual development we run the risk of significantly increasing the future burden to the individual and to society at large.  Early detection and prevention is crucial.
  5. In some instances, testing for Learning-related Vision Problems may require a referral to a doctor of optometry with advanced training in this area of practice.

The benefits of the recommendations in this guideline were established by expert consensus opinion after review of thousands of studies and resources, with the AOA Evidence-Based Committee and Multidisciplinary and Patient Stakeholders acknowledged at the end of the document.

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