Current vision screening recommendations for older adults have merit, says Paul Lee in JAMA

ANN ARBOR, Mich. - The chair of ophthalmology at the University of Michigan examined a recent report investigating the value of vision screening for older adults with no symptoms.

Paul Lee’s editorial, published online today in JAMA, explains the U.S. Preventive Services Task Force report, also published today in JAMA.

The USPSTF work states that current evidence doesn’t allow for assessment of clear recommendation supporting the use of visual acuity in screening those 65 and older who have no symptoms and are not already under eye care.

Lee’s editorial highlights the strengths of the task force’s methods while acknowledging some difficulties in carrying out the recommendations of the task force and the possible implications of ongoing change in the care delivery system.

Strengths mentioned in the editorial include:

The specific description of the population studied - Individuals aged 65 and older who have not sought care for evaluation of vision problems and who do not have any known symptoms or visual impairments.
A clear assessment of both the value of treating diseases the screening should detect, like cataracts, while also explicitly reviewing the harms associated with false positives or screening errors.
Difficulties of the USPSTF process, according to Lee, include:

The high degree of rigor makes it challenging to complete the randomized clinical trials with the specific population.
The time required to conduct appropriate studies might not be able to keep up with changes in current health delivery approaches.

Lee, who directs the U-M Kellogg Eye Center, is a member of the U-M Institute for Healthcare Policy and Innovation.

Disclosure: Lee receives support from the Centers for Disease Control and Prevention and the Foundation of the American Academy of Ophthalmology/American Academy of Ophthalmology.

Reference: “Visual Acuity Screening Among Asymptomatic Older Adults,” The Journal of the American Medical Association, March 1, 2016. doi:10.1001/jama.2016.1271.