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April 2016

The USPSTF Position on Vision Screening of Adults—Seeing Is Believing?

Author Affiliations
  • 1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
JAMA Intern Med. 2016;176(4):438-439. doi:10.1001/jamainternmed.2016.0222

In 2009, the US Preventive Services Task Force (USPSTF) concluded that there was insufficient evidence to warrant recommending visual acuity screening of older adults. A recent update, published in JAMA,1 reaches the same conclusion. How (one might ask) can that be, especially as the USPSTF also concluded that impaired vision is common among elderly adults and that the major causes of impaired vision that the recommendation targets—refractive error, cataract, and age-related macular degeneration—are prevalent among elderly individuals and responsive (often dramatically) to clinical intervention? Simple: available data, such as they are, suggest that those screened see no better 1 to 4 years later than do controls.24 In addition, there are little data available on the harm that such screening might incur (primarily associated with treating the condition causing the impaired vision; eg, infectious keratitis among those who might receive contact lenses for correction of their refractive error).

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