School Vision Screening Program Research Articles

The problem of myopia in the practice of a family doctor

Myopia (nearsightedness) is the most common type of refractive error and is a growing global public health issue affecting quality of life and work productivity. Myopia is most often associated with axial elongation of the eyeball and can be caused by both hereditary and environmental factors. The global prevalence of myopia is estimated to rise to 5 billion people by 2050, of whom nearly 1 billion people are likely to develop high myopia. Stopping the development and progression of myopia is critical as high myopia is the leading cause of blindness worldwide. Despite the growing awareness of myopia, the practice of its treatment and prevention remains unchanged among practicing family physicians. The mechanism of many myopia treatments and their role in high myopia are still unclear. In the absence of any established clinical guidelines for the treatment of myopia, the best treatment strategy is to study modifiable risk factors, develop preventive strategies, and possibly integrate them with school vision screening programs.

Variations in the prevalence of vision impairment across regions among school children in Telangana State, South India.

Undetected vision impairment (VI) could negatively affect the overall development in children. School vision screening program is a viable and cost-effective approach for the early identification and management of VI. This study aims to estimate the prevalence of VI, its risk factors, and ocular morbidity among school children in Telangana, South India. Children aged 4-15 years attending schools in the study area were screened in this study. The vision screenings were performed in schools by trained community eye health workers using 6/12 tumbling E optotypes. Children who failed the test and/or presented with other eye conditions were referred to vision centers or secondary and tertiary eye care centers. A comprehensive eye examination was conducted in these centers, including cycloplegic refraction and fundus examination. A total of 774,184 children, with a mean age of 9.4 ± 3.27 years, were screened. Overall, 51.49% (N = 398,596) were male. In total, 4.33% [N = 33,528; 95% confidence interval (CI): 4.29-4.38] required referral services, while 1.16% (N = 9,002) had a presenting visual acuity of < 6/12. Multivariate analysis showed a high risk of VI among older children [Adj. odds ratio (OR): 5.75; 95% CI: 5.18-6.38], those with disabilities (Adj. OR: 5.12; 95% CI: 4.14-6.33), female gender (Adj. OR: 1.29; 95% CI: 1.24 - 1.35), and those residing in the urban areas (Adj. OR: 2.87; 95% CI: 2.42-3.39). The main cause of VI was uncorrected refractive errors (74.14%). The prevalence of VI among school children was 1.16% in Telangana, South India, and refractive error was the leading cause of VI among this population. Increasing age, urban location, female gender and other disabilities increase the risk of VI among children.

Non-compliance for wearing spectacles: Prevalence and determinants in school-going children in South India.

To study the prevalence and determinants of compliance with spectacle wear among school-age children in South India who were given spectacles free of charge under a school vision screening program. A cross-sectional, descriptive study was performed. The participants were recruited from the school from Tirunelveli and Tuticorin districts of Tamil Nadu, where a school vision screening camp was conducted between January 2012 and October 2012. The school screening was performed under. . Of the 129,720 children examined of 249 schools, 4253 of children had refractive error and 3333 were prescribed and dispensed spectacles. A total of 683 children were interviewed, who were not wearing glasses on follow-up. About 20% of the participants (683/3333) were not wearing their spectacles at examination. The most common reasons given for non-wear were lost (44.9%) or broken (35.3%) spectacles. There was no gender preference on compliance to spectacles. Compliance with spectacle wear is less even when spectacles are provided free of cost, particularly in children among the age group of 5-15 years. Because factors such as type of school, area (urban or rural), parent's income, occupation, and their education were not significantly affecting the compliance of spectacle wear, proper encouragement and counseling of the parents and the child become extremely important.

Prevalence of myopia in school-age children in Ethiopia: A systematic review and meta-analysis.

This study aimed to estimate the pooled prevalence of myopia among school-age children in Ethiopia. Eligible articles were searched from PubMed, Embase, and Web of Science databases. In addition, Google Scholar and reference lists of the retrieved articles were searched from 30 July 2022 to 02 January 2023. The preferred reporting of items for systematic reviews and meta-analysis was used to report the search results. Microsoft Excel was used to keep the data. The qualities of eligible studies were checked using the Joanna Briggs Institute critical appraisal checklist for prevalence studies. Analysis was held using STATA Version 11. The degree of heterogeneity was checked using I² statistics. The possible sources of heterogeneity were examined using meta-regression and subgroup analyses. The funnel plot and Egger's test were used to assess the potential publication bias. A correction was made for publication bias using Duval and Twee Die's trim-and-fill analysis. The systematic review registration number is PROSPERO (#CRD42022330541). We identified 21 eligible articles including 20,757 subjects. Of those participants, 10,601 (51.1%) and 10,156 (48.9%) were males and females, respectively. A total of 15,152 (73%) participants were urban residents. The estimated prevalence of myopia among school-age children in Ethiopia was found to be 5.26% (95% confidence interval: 4.09-6.42). The prevalence of myopia among school-age children in Ethiopia is considerable, affecting one in 20 school-age children. Therefore, the authors recommend the stakeholders take extra steps to speed up the implementation of the school vision screening program and its integration plan into the existing school nutrition program.

Evaluation of a combined school-based vision screening and mobile clinic program

Uncorrected refractive error can lead to lowered academic performance. Many children depend on state-mandated school vision screening programs. Effective screening programs require follow-up with eye care providers, but studies demonstrate poor follow-up rates after failed screenings. Programs have attempted to mediate this issue by providing free examinations and glasses after failed screenings. This study presents data from a mobile clinic program that provides instrument-based vision screening, eye examinations, and free glasses directly to children at school.

The MTT: A More Comprehensive Vision Screening Test for British Columbia Schools

Literature regarding the vision care needs of school children indicates that visual anomalies occur in sufficient numbers to warrant recommen­dation of a comprehensive school vision screening program. This study investigated the referral effec­tiveness (accuracy) of the Keystone Telebinocular (KTT), the Modified Telebinocular (MTT) and the Snellen against a standard optometric exam.

A study on the prevalence of ocular disorders among school going children in the age group of 5 to 12 years

The aim of this study is to assess the prevalence of various ocular disorders among school going children in the age group of 5 to12 years. : Vision screening is crucial for early detection of ocular disorders among young children thereby preventing the risk of uncorrectable dimunition of vision. Hence, our programme is planned as early detection of the causative factors in the childhood period and most effectively treat as early as possible.The purpose of the screening programme is to identify various ocular diseases in children like refractive errors, amblyopia, defective color vision, lid and adnexal disorders, vitamin A deficiency, allergic conjuctivitis, glaucoma, cataract and squint. Identification of such problems and its correction in early stage is crucial for their normal growth. A school based prospective cross sectional study design was adopted to examine children aged 5–12 years in randomly selected schools of Kollam district from January 2020 to March 2020. In this cross-sectional study, two Optometrist and two Ophthalmologist and other supportive staffs screened 3100 school children aged 5 to 12 years for vision and external eye examination. An Optometrist did the visual acuity testing and refraction. Detailed ophthalmic examination was done by an Ophthalmologist. The pattern of visual acuity, colour vision and ocular disorders were studied. Children needing further assessment were referred to the hospital and analysis of the data and data entry done using Microsoft office excel 2016 with Statistical software: R software (EZR 1.32).: A total number of 3100 students from 11 different schools were examined, 1570 of whom were males, and 1530 were females. The commonest eye disorder was refractive error 16.6% (514) in which most common was myopic astigmatism 78.2% (402) of which 322 were against the rule and 80 were with the rule astigmatism, followed by simple myopia 15.2%(78) simple hypermetropia 4.7%(25) and hypermetropic astigmatism 1.7%(9). Of these spectacles usage was found to be present only in 81.3% (418) students, rest 18.7%(96) were not aware of the refractive error. Next common eye disorder was allergic conjunctivitis 1.6%(49).Squint was present in 1.4%(42) children. Corneal opacity was present in 0.26%(8), defective color vision was there in 0.2%(6); lids and adnexal disorders 0.13%(4) and cataract 0.03%(1). There were no students with congenital anomalies, congenital glaucoma or Vitamin A deficiency. Uncorrected refractive error is the most common visual impairment found in school going children. There is a need to set up a regular school vision-screening programme to detect ocular disorders in order to prevent the burden on society on long term. Since most of this morbidity is either preventable or completely treatable, school screening is an effective method to reduce this burden.

English

BACKGROUND The prevalence of refractive errors is reported to be higher in children born preterm. Factors like gestational age, birth weight and retinopathy of prematurity status have a significant impact on the refractive development in preterm infants. Population based long term follow up studies on the refractive status in preterm infants are limited. We designed this study to assess whether prematurity is a risk factor for refractive errors in children. METHODS This study was conducted among children aged 5 - 16 years who participated in the school vision screening program over a period of one year. All children underwent detailed ocular examination including measurement of best corrected visual acuity, cycloplegic refraction and fundoscopy. Visual acuity was assessed using an internally illuminated Snellen’s chart at 6 meters. Objective refraction by streak retinoscopy after instilling 1 % cyclopentolate eye drops was done in all children with visual acuity ≤ 6 / 9. Children were divided into two groups based on their gestational age at birth - preterm group and full-term group. Preterm birth was defined as childbirth before 37 completed weeks of gestation. Children were enrolled in the study only if the hospital birth document showing gestational age and birth weight was available. Children with co-existing organic disease affecting the eye contributing to the diminished visual acuity such as congenital cataract, glaucoma, and corneal opacities were excluded from the study. Those who had undergone any ocular surgery were also excluded. RESULTS One thousand two hundred and ninety-five children were enrolled in the study of which 700 (54.1 %) were boys and 595 (45.9 %) were girls. Median age of the enrolled children was 12 years. The number of pre-term births was 287 (22.2 %). Of the 1295 students screened, 273 (21 %) had refractive errors. Among the children with refractive errors, astigmatism was the most common refractive error (10.6 %), followed by myopia (8.5 %) and hypermetropia (1.9 %). Refractive errors were statistically more prevalent in preterm group (34.1 %), when compared with term born children (17.3 %), p = &lt; 0.001. Compared to the term born children, preterm group had significantly higher prevalence of myopia; 16.4 % vs 6.3 % (p = &lt; 0.001) and astigmatism; 15.3 % vs 9.3% (p = 0.003). There was no statistically significant difference in the prevalence of hypermetropia among the two groups; 2.4 vs. 1.8 (p = 0.477). CONCLUSIONS There is strong association between prematurity and refractive errors. These findings prompt long term monitoring of the refractive and visual outcome in preterm infants for diagnosing refractive errors at the earliest. This helps to prevent the consequent amblyopia and the ensuing permanent visual function deficits. KEYWORDS Prematurity, Refractive Error, Myopia, Hypermetropia, Astigmatism

School screening in Coastal Karnataka

Objective. The objective of this study was to determine the prevalence of visual impairment and blindness among students in 13 schools in coastal Karnataka and to determine the most common causes for the same. Materials and Methods. This was a prospective cross-sectional study. A total of 833 students from 13 different schools were screened as a part of the school screening programme. The examiners were an ophthalmologist and an ophthalmic assistant. For all the students, visual acuity (VA) was measured with a Snellen chart, color vision was done using an Ishiaras chart, fundus examination was done using a direct ophthalmoscope, while students with subnormal vision (VA ≤ 6/ 9) were examined using pinhole, and referred for detailed eye examination and clinical refraction. Results. The age range was from 6 to 16 years comprising 390 males and 443 females. Refractive error in either eye was present in 69 of these students of which myopic astigmatism was the commonest type. This was followed by allergic conjunctivitis 15 cases, amblyopia 3, squint 2, lids and adnexal disorders in 2 students; defective color vision was seen in 8 students, all of whom were males. Spectacle usage was found to be present only in 11 students, who showed lack of awareness concerning eye care and possibly the lack of access to health care. There were no students with retinal or posterior segment disorders. Conclusions. Uncorrected refractive error is the most common visual impairment found in schools students in coastal Karnataka and there is a need for the establishment of a regular school vision-screening program to detect such problems in order to prevent the burden on society due to the long life span ahead.

Implementing a School Vision Screening Program in Botswana Using Smartphone Technology.

Purpose: Child eye health is a significant public health issue in low- and middle-income countries, such as Botswana, and the need for eye care requires a well-integrated and innovative approach. Traditional vision screening tools are costly, difficult to transport, and reliant on highly trained eye care professionals. Novel smartphone-based vision screening technologies, however, are low cost, portable, and easily operated by trained novice users. Peek Vision is a mobile health (m-Health) organization that creates smartphone applications that screen for visual acuity, generate referrals to eye care professionals, and send phone notifications to those being screened. Methodology: In 2016, the government of Botswana partnered with local and international stakeholders to implement Peek vision screening in a subset of schoolchildren. From June to December of 2016, teachers, health assistants, nurses, and other volunteers in 49 schools in the Goodhope Subdistrict utilized Peek applications to screen schoolchildren, using acuity <6/12 in the better eye as a threshold for visual impairment. Results: Among 12,877 children screened, the application identified 16% (2,065/12,877) as screening positive for visual impairment, and these students were referred for optometric care. Ultimately, 96% (1,985/2,065) attended optometry triage camps, during which 42% (835/1,985) were provided with spectacles, 5% (94/1,985) received ophthalmic medications, and 3% (63/1,985) were referred for ophthalmic care. These findings underscore the need for comprehensive vision screening in schoolchildren in Botswana. Furthermore, the successful implementation of Peek smartphone applications illustrates the potential of m-Health technology for enacting comprehensive vision screening programs at a national level in Botswana and other similar countries.

Effectiveness of interventions in improving compliance to spectacle wear and referral in school vision screening

BackgroundSuccess of a school vision screening program depends on compliance with the advice that is offered to the children. This study evaluates the effect of an intervention package on compliance to spectacle wear and referral in a school vision screening program.MethodsAmong 8,442 children aged 13–17 years in 11 government schools in and around Chennai, India, 114 (2.2 per cent) children who required spectacles were allocated to the control arm (5,116 children) and 124 (3.7 per cent) children to the intervention arm (3,326 children). There were 44 (0.9 per cent) children in the control arm and 49 (1.5 per cent) children in the intervention arm who required referral for further management. Control schools received a conventional school screening protocol and intervention schools received 23‐step interventions. Spectacle wear was noted in an unannounced direct observation after one, four and 12 months. Compliance to referral was noted based on the response of children with confirmation from medical records.ResultsSpectacle compliance was significantly higher for the intervention arm compared to the control arm based on direct observation in the first month (17.6 per cent versus 49 per cent, adjusted odds ratio [OR] = 4.4, 95 per cent confidence interval [CI] 2.3–8.5, p < 0.05); in the fourth month (23 per cent versus 56 per cent, OR = 4.2, 95 per cent CI 2.3–7.8, p < 0.05); and in the 12th month (13.3 per cent versus 38.8 per cent, OR = 4.1, 95 per cent CI 1.8–9.4, p < 0.05). Referral compliance was significantly higher in the intervention arm in the first month (17.5 per cent versus 70.5 per cent, OR = 10.9, 95 per cent CI 3.8–30.9, p < 0.001) and in the fourth month (31.7 per cent versus 75.6 per cent, OR = 6.2, 95 per cent CI 2.3–16.0, p < 0.001).ConclusionA 23‐step package of interventions was effective in improving compliance to spectacle wear and referral among adolescents in a school vision screening program.

Agreement and diagnostic accuracy of vision screening in children by teachers, community eye‐health workers and vision technicians

BackgroundTo compare the agreement and diagnostic accuracy of vision screening conducted by trained community eye‐health workers (CEHWs) and teachers with reference to vision technicians in Movva Mandal (sub‐district) in Krishna District in the Indian state of Andhra Pradesh.MethodsAs part of a large epidemiological study on visual impairment in children, vision screening was conducted in all the schools in a sub‐district. The children were screened using a screening card with 6/12 tumbling E optotypes by trained CEHWs, teachers and a vision technician. Teachers were included if they had screened at least 100 children and had at least five children identified with visual impairment.ResultsOf a total 6,197 children from 75 schools, 4,929 children were screened by all three categories of examiners (one vision technician, five CEHWs and 79 teachers). The overall agreement between the vision technician and CEHWs was 0.84 (95 per cent CI: 0.79–0.9) with a range of 0.77–0.9. Overall sensitivity of CEHWs to detect visual impairment was 83.3 per cent (95 per cent CI: 73.6–90.6) with a range of 71.4–87.1 per cent. Overall agreement of the five teachers with the vision technician was 0.81 (95 per cent CI: 0.74–0.88) with a range of 0.32–0.92. The overall sensitivity of teachers to detect vision problem was 72.3 per cent (95 per cent CI: 61.4–81.6) with a range from 20 per cent to 85.7 per cent and specificity was near 100 per cent.ConclusionThere was no significant difference in the agreement and diagnostic accuracy of CEHWs and teachers compared to those of the vision technician. There was a large variability among teachers, which needs to be considered in school vision screening programs.

Final Visual Outcomes and Treatment Received for Children Referred from a UK Primary School Visual Screening Program: A Comparison of An Orthoptic-led Program with Orthoptic-delivered Services

ABSTRACTThere is little published evidence relating to the final visual acuity of children who are identified as having reduced vision at a school screening program. The school vision screening program in Leeds (led by an orthoptist but delivered by health care support workers within the school nursing team) is examined.Results: 7807 children were screened in school between November 1, 2013, and September 1, 2014. Of these, 319 (4%) failed the screen and were referred to the general optometry service and 547 (7%) were referred to the Children’s Community Eye Service (CCES). Of the children who were referred to the CCES, 79.4% attended their first appointment and 86.4% were positive referrals. Of the children with reduced vision, 31 (8.3%) were found to have a manifest strabismus or eye movement disorder; 75 (20% of the positive referrals) required occlusion therapy for amblyopia; 52.6% of those with initially reduced vision obtained good visual acuity following spectacle correction alone within an 18- to 24-week refractive adaptation period. Of those who completed their treatment, 92.9% had vision within normal limits for their age in both eyes at discharge. Of children referred from vision screening who were found to have a defect, 64.6% had that treatment completed within three visits.Conclusion: Vision screening identifies individuals with treatable vision defects who have a greater than 90% chance of achieving normal visual acuity with good compliance to treatment. Vision screening programs led by an orthoptist but delivered by well-trained and monitored screeners can be of as good quality as a screening program delivered by orthoptists.

Outcomes of an Australian Nursing Student-led School Vision and Hearing Screening Programme

ABSTRACTNursing students typically do not undertake clinical training in school settings. However, they are well placed to have a role in providing health screening and education in schools or community health venues under supervision of qualified nurses. This study provides a description and outcomes of a vision and hearing screening programme delivered by university nursing students working out of a student-led clinic situated in an underserved, largely Aboriginal and Torres Strait Islander community in regional Australia. Screening and follow-up data collected from 741 elementary school children indicated some important population patterns and trends, with nearly 30% having identified problems. Anecdotal evidence suggested children who gained treatment had improved school performance. Challenges to follow-up and confounding variables are discussed and a suggestion for future research is offered.

Screening efficacy of a simplified logMAR chart

Background: Snellen acuity charts are the most commonly used method for visual acuity (VA) testing in screening programmes despite comparative studies verifying that the logarithm of minimum angle of resolution (logMAR) acuity measurement charts are more accurate than the Snellen chart acuity measurements. LogMAR acuity measurement charts however are not well implemented in routine clinical practice because of the increased testing time and the complexity of scoring. To implement the logMAR method in a screening programme, there has to be some simplification of it.Aim: This study evaluates the efficacy of a simplified logMAR chart, designed for VA testing over the conventional Snellen chart, in a school-based vision-screening programme.Methods: We designed a simplified logMAR chart by employing the principles of the Early Treatment Diabetic Retinopathy Study (ETDRS) chart in terms of logarithmic letter size progression, inter-letter spacing, and inter-line spacing. Once the simplified logMAR chart was validated by students in the Elite school vision-screening programme, we set out to test the chart in 88 primary and middle schools in the Tiruporur block of Kancheepuram district in Tamil Nadu. One school teacher in each school was trained to screen a cross-sectional population of 10 354 primary and secondary school children (girls: 5488; boys: 4866) for VA deficits using a new, simplified logMAR algorithm. An experienced paediatric optometrist was recruited to validate the screening methods and technique used by the teachers to collect the data. Results: The optometrist screened a subset of 1300 school children from the total sample. The optometrist provided the professional insights needed to validate the clinical efficacy of the simplified logMAR algorithm and verified the reliability of the data collected by the teachers. The mean age of children sampled for validation was 8.6 years (range: 9–14 years). The sensitivity and the specificity of the simplified logMAR chart when compared to the standard logMAR chart were found to be 95% and 98%, respectively. Kappa value was 0.97. Sensitivity of the teachers’ screening was 66.63% (95% confidence interval [CI]: 52.73–77.02) and the specificity was 98.33% (95% CI: 97.49–98.95). Testing of VA was done under substandard illumination levels in 87% of the population. A total of 10 354 children were screened, 425 of whom were found to have some form of visual and/or ocular defect that was identified by the teacher or optometrist.Conclusion: The simplified logMAR testing algorithm proved to be less time consuming than the standard logMAR test. This suggests that the simplified logMAR chart is effective in vision-screening programmes and would be a reliable alternative to the standard logMAR chart and therefore replace the use of Snellen chart acuity tests in vision-screening programmes. The study also showed that non-healthcare providers, such as teachers, can reliably administer the simplified logMAR test.Keywords: vision screening; school children; vision screening standards; screening reliability

Impact of visual acuity on developing literacy at age 4–5 years: a cohort-nested cross-sectional study

ObjectivesTo estimate the prevalence of poor vision in children aged 4–5 years and determine the impact of visual acuity on literacy.DesignCross-sectional study linking clinical, epidemiological and education data.SettingSchools located in...

Vision screening to detect refractive errors in three selected secondary schools in Birnin Kebbi, North West, Nigeria

Objective: The objective of this study was to determine the prevalence of uncorrected refractive error among students in three selected secondary schools in Birnin Kebbi metropolis as many children with poor vision due to refractive error remain undiagnosed and perform poorly in schools. Materials and Methods: This was a cross-sectional study that was conducted over a period of 2 months (May-June 2014). A total of 614 students were included from three randomly chosen secondary schools in Birnin Kebbi, Nigeria. Subjects were selected using random sampling technique from the list of students available through the help of their class teachers. Visual acuity (VA) was measured with a Snellen chart, while students with subnormal vision (VA ≤ 6/9) were examined using pinhole, and subsequently referred for detailed eye examination and retinoscopy evaluation. Results: The age range was from 11 to 20 years comprising 50.8% (n = 312) males and 48.2% (n = 302) females. Refractive error in either eye was present in 30 (4.8%) children. Of these, myopia was diagnosed in 18 (60%) children, and then hyperopia in 7 (23.3%), and astigmatism in 5 (16.7%) subjects. Spectacle coverage was low as only three pupils were found to be using glasses with lack of awareness and lack of access to eye care services as major barriers. Conclusions: Uncorrected refractive error is found among secondary schools students in Birnin Kebbi, and there is a need for the establishment of regular and effective school vision screening program to detect and refer patients for treatment.

Vision Screening by Teachers in Southern Indian Schools: Testing a New “All Class Teacher” Model

Aim: To study the effectiveness and cost of a new school vision screening program involving all class teachers (ACTs) compared with the standard program involving a limited number of selected teachers (STs) in Southern India.Methods: A total of 12 schools were selected for intervention and 12 schools were matched as controls, from in and around Pondicherry, India. Teachers in both the intervention arm (ACTs) and the standard arm (STs) were trained to identify students between the ages of 6 and 17 years with visual acuity ≤20/30 in either eye or obvious ocular abnormalities and refer them to an ophthalmic team. The ophthalmic team, including an ophthalmologist, visited the schools to examine all children referred by teachers, provided medical treatment or a prescription for glasses, or referred them to the base hospital if required.Results: ACTs (761 teachers) screened 39,357 children (97.7%) and STs (156 teachers) screened 38,469 children (95.7%). ACTs found significantly fewer screen-positive children (n = 3806, 9.7%) than the STs (n = 6387, 16.6%; p < 0.001), but had a significantly larger number of children with actual vision loss and other ocular pathology (2231, 5.7% and 1554, 4.0%, respectively, p < 0.001). More children from ACTs than STs reached the base hospital for further investigation within 3 months (p < 0.001). The cost of screening per child with actual ocular pathology was estimated to be US$1.91 for ACTs and US$4.83 for STs.Conclusions: A school vision screening program involving ACTs resulted in more efficient screening than a program involving STs at about a third of the cost and also improved compliance with hospital referral.

Is myopia a public health problem in India?

Myopia, a form of refractive error is a leading cause of visual disability throughout the world. In India uncorrected refractive errors are the most common cause of visual impairment and second major cause of avoidable blindness. Due to this the public health and economic impact of myopia is enormous. Although school vision screening programme is very successful in many states, still a significant number of school going children remain unidentified and the unmet need for correcting refractive errors in children appears to be significant.

Pilot Study: A Review of Personnel Involved in School Vision Screening and the Training Module in Betong, Malaysia

Introduction: School vision screening program is a scheduled program under the Ministry of Health, Malaysia for 7, 12 and 15 years-old children in the government schools. The aim of this study was to review the school vision screening program from the perspective of the personnel involved as the screener. Methods: The evaluation of the performance of the screener was based upon the accurate referrals' outcome from the school health database of Betong Division in Sarawak, Malaysia in the year of 2008. Results: The total accuracy of the referrals was 50.7%. Lower accuracy of the referrals was found significantly associated with Grade 1 [χ2 (2.N=304) = 28.810, p&lt;0.001, OR 4.472, CI.95= 0.843=2.335] and among Native Iban [χ2 (2.N=304) = 7.901, p&lt;0.05, OR 1.502, CI.95= 0.935=2.414]. Conclusions: Further review on the training modules demanded improvement and enhancement to suggest that training module might be one of the contributing factors on the performance of the screener.