By Nigel Little
Glasses for children or contact lenses are not being prescribed early enough due to inadequate implementation of Department of Health (DoH) policy on providing sight tests for children from the age of four according to a recent 'Which?' investigation. Of the 110 Primary Care Trusts (PCTs) in England, 10% confirmed that they did not arrange sight tests for 4-5 year olds as expected by the DoH and a further 38% did not respond at all suggesting that the percentage of young children being denied tests is even higher. As such, avoidable vision problems or problems which can be readily addressed by early diagnosis and treatment are potentially remaining undetected for an extended period of time.
Even where PCTs are offering sight tests for young children, the actual uptake ranges widely from as low as 35% up to 99% which the report suggests represents yet another example of a postcode lottery when it comes to organising the eye tests and getting parental agreement. Additionally, many PCTs were unable to confirm how many children who received a sight test were then referred for further testing whilst those that did capture the data reported referrals ranging from 0-39%. Eye health expert Professor David Thomson of City University says: "An estimated 10% to 20% of children are likely to have a significant vision problem that can be detected with a simple three-minute test." Without testing, an early requirement to prescribe glasses for children may not be actioned leaving the problem to potentially worsen with consequent issues for the child's academic and personal development.
In the light of severe budgetary pressures throughout the public healthcare system, it is easy to imagine that this failure to test on the part of the PCTs is related to financial constraints and is unlikely to change given the DoH's lukewarm response to Which? when challenged on the results of their investigation. The DoH stated: "We are aware that some areas are screening more children than others and we are encouraging regional Directors of Public Health to match best practice." As such, it requires parents to be made more aware of the importance of having their young children undergo a sight test as they commence primary school to ensure they are not disadvantaged by vision problems at an important stage in their development. Prescribing glasses for children or contact lenses at the earliest opportunity when a problem is detected could provide a lifetime benefit.
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