Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I thank the Senator for focusing on this important issue and giving me an opportunity, on behalf of the Minister for Health, to address the issue of eye-testing for primary school children. A child's vision continues to develop until about the age of eight years. Vision surveillance and screening are conducted by hospital paediatric teams, public health nurses and general practitioners, depending on the stage of development, to identify children with a visual impairment or eye conditions that are likely to lead to visual impairment in order that a referral can be made to an appropriate eye care professional for further evaluation and treatment. Vision screening is carried out under the guidance of the HSE's national screening and surveillance programme, Best Health for Children Revisited. Children have their eyes checked at birth by the paediatric team in the hospital. Their eyes are also checked by a public health nurse during the neonatal visit and the GP during the two and six-week visits. Children have universal access to an ongoing vision surveillance programme provided by the public health nursing service until they commence school. The purpose of the vision screening children undergo when they enter school is to detect amblyopia, the reduction of visual acuity in one or both eyes, usually in an otherwise normal eye. It needs to be identified and managed before the age of eight years. A child who has a vision issue detected during preschool or primary school screening receives a HSE service provided by community ophthalmic physicians or a hospital until the age of 16 years. All children are eligible to have an eye examination and receive treatment until the age of 12 years. If the parents of a child have a medical card, the child will be eligible to have an eye examination and receive treatment until he or she is 16 years.

The HSE published the report of the primary care eye services review group in June 2017. The review group determined that there was a need to move from the management of all referrals by community ophthalmic physicians to a model centred on primary eye care teams. The report recommends that such teams be based in primary care settings, with optimum accommodation, facilities, equipment and resources. Each team will provide services along care pathways, as set out in the report, for children and adults and work in an integrated fashion supported by an IT patient management system. This will ensure hospital services are focused on patients who require more specialist diagnostics or treatments.

Further to a recommendation made in the review group's report, the HSE is in the process of agreeing an addendum to the community ophthalmic services scheme to allow children aged eight years and over to be seen by their local community optometrist. The HSE is in the process of establishing primary eye care teams in south and west Dublin and further developing a team in north Dublin. The report recommends that all routine sixth class screenings, including the colour vision test, be discontinued as there is little clinical evidence for providing visual screening for children in sixth class. Data have shown that very few or no new cases of eye diseases such as amblyopia are detected at that stage. Most countries no longer undertake school exit screening. Instead, screening is undertaken at an earlier age to ensure children with eye diseases are identified at the earliest possible stage and can access treatment services.