OTTAWA, ON, May 14, 2018 – Today the Canadian Task Force on Preventive Health Care (CTFPHC) made a recommendation against screening for impaired vision in primary care settings among those aged 65 who live independently in the community and who have not reported concerns about their vision.
People with a visual acuity worse than 20/40 are at higher risk of fall-related injuries, social isolation and poor health outcomes.
In Canada, optometrists provide routine eye checks, and people who suspect they have a visual problem can consult an optometrist or bring it to the attention of their family physician. Those who have a driver’s license must also undergo an eye check as part of their driver’s license medicals at varying ages in different provinces.
The CTFPHC considered the possible health benefits of also screening for visual impairment in primary health care among people who have not reported concerns about their vision and to refer individuals, when necessary, to eye care practitioners for formal vision testing. The CTFPHC considered evidence from a systematic review that included 15 randomized clinical trials of participants aged 65 years or older.
“We found no evidence of benefit to patients – in terms of important health outcomes – from being actively screened for impaired vision in primary care settings,” said Dr. Brenda Wilson, who chaired the guideline working group. “The CTFPHC has therefore recommended against screening for impaired vision in primary care settings among those without vision concerns.” Dr. Wilson added, “This does not mean that eye testing by eye care professionals is not valuable. Rather, it means that there seems to be no added benefit to people’s health by asking primary health care practitioners to do routine screening when there are not specific concerns.”
Dr. Wilson pointed out that the resources that would be used by primary care practitioners for screening older people would be better directed towards beneficial activities that are supported by good evidence.
The Guidelines are published today in the Canadian Medical Association Journal (CMAJ) in English and French. The Guidelines, developed by the CTFPHC, an independent body of primary care and prevention experts, examined the best and most current scientific evidence related to screening tests to formulate the screening recommendations.
Vision Impairment in the Future
The absolute rate of impaired vision in Canada is expected to increase nearly 30 per cent in the next decade, because of the demographic impact of an aging population.
“Understanding how to support healthy aging and sustained independence in older people is increasingly important as the Canadian population ages,” said Dr. Brett Thombs, Chair of the CTFPHC. “Although routine screening in primary care does not seem to be effective, there may be other ways to support older people to maintain their vision and stay active. We hope that research will help us to identify possible options.”
For the complete report and details on the CTFPHC’s findings and recommendations and accompanying patient and clinician Knowledge Translation tools, please visit: www.canadiantaskforce.ca
About the Canadian Task Force on Preventive Health Care
The Canadian Task Force on Preventive Health Care (CTFPHC) has been established to develop clinical practice guidelines that support primary care providers in delivering preventive health care. The mandate of CTFPHC is to develop and disseminate clinical practice guidelines for primary and preventive care, based on systematic analysis of scientific evidence.