Effectiveness of using teachers to screen eyes of school-going children in Satna district of Madhya Pradesh, India.
OBJECTIVE
To assess the effectiveness of teachers in a vision screening program for children in classes 5th to 12th attending school in two blocks of a district of north central India.


METHODS
Ophthalmic assistants trained school teachers to measure visual acuity and to identify obvious ocular abnormalities in children. Children with visual acuity worse than 20/30 in any eye and/or any obvious ocular abnormality were referred to an ophthalmic assistant. Ophthalmic assistants also repeated eye examinations on a random sample of children identified as normal (approximately 1%, n=543) by the teachers. Ophthalmic assistants prescribed spectacles to children needing refractive correction and referred children needing further examination to a pediatric ophthalmologist at the base hospital.


RESULTS
Five hundred and thirty teachers from 530 schools enrolled 77,778 children in the project and screened 68,833 (88.50%) of enrolled children. Teachers referred 3,822 children (4.91%) with eye defects for further examination by the ophthalmic assistant who confirmed eye defects in 1242 children (1.80% of all screened children). Myopia (n=410, 33.01%), Vitamin A deficiency (n=143, 11.51%) and strabismus (n=134, 10.79%) were the most common eye problems identified by the ophthalmic assistant. Ophthalmic assistants identified 57.97% referrals as false positives and 6.08% children as false negatives from the random sample of normal children. Spectacles were prescribed to 39.47% of children confirmed with eye defects.


CONCLUSIONS
Primary vision screening by teachers has effectively reduced the workload of ophthalmic assistants. High false positive and false negative rates need to be studied further.
Sudhan
Anand
A
Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Jankikund, Satna District, Chitrakoot, Madhya Pradesh, India. kanandsudhan@yahoo.com
Pandey
Arun
A
Pandey
Suresh
S
Srivastava
Praveen
P
Pandey
Kamta Prasad
KP
Jain
Bhudhendra Kumar
BK
D000293:Adolescent; D001766:Blindness / Q000453:epidemiology / Q000517:prevention & control*; D002648:Child; D005178:Faculty; D005189:False Positive Reactions; D006801:Humans; D007194:India / Q000453:epidemiology; D015995:Prevalence; D012030:Refractive Errors / Q000175:diagnosis* / Q000453:epidemiology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012424:Rural Population; D015351:Vision Screening / Q000379:methods*; D014792:Visual Acuity