Paediatric vision screening by non-healthcare volunteers: evidence based practices

Abstract

BackgroundThe purpose of this study was to test the sensitivity and specificity of eight undergraduate volunteer examiners conducting vision screening tests in a community setting, in order to determine if non-eye care professionals were able to be trained to an appropriate level of skill.MethodsEight undergraduate volunteer examiners were trained to conduct vision screening tests to address a gap in pediatric community eye care. Phase I of the study was implemented in the pediatric ophthalmology clinic, and phase II was conducted in nine local schools. Phase I consisted of 40 h of training for each volunteer regarding specific vision tests. Phase II consisted of screening children at nine local schools.ResultsA total of 690 children from nine local schools were screened by both the volunteer examiners and the optometrist during the course of this study. Volunteer examiners had a screening sensitivity of 0.80 (95%CI 0.66–0.90) and screening specificity of 0.75 (95%CI 0.71–0.78) when compared to the study optometrist. The overall accuracy of volunteer examiners was 75%. The resulting positive likelihood ratio was 3.24 (95%CI 2.6–3.9), indicating that a child with vision impairment was 3.2 times more likely to fail the vision test performed by the volunteer examiners compared to a child with no vision impairment.ConclusionsNon-healthcare professionals can be trained to an acceptable degree of accuracy to perform vision screening tests on children, which may assist in mitigating existing gaps in paediatric eye care.