Vision Screening and Eye Examination of School Children

Vision screening and eye examination are important for the detection of conditions that distort or suppress the normal visual image and, ultimately, may lead to blindness in children. Examination of the eyes can and should be performed at any age, beginning in the newborn period. Vision screening should be performed at as early an age as is practicable. Conditions that interfere with vision are of grave import because visual stimuli are critical to the development of normal vision. Decreased visual acuity often contributes to inadequate school performance. In addition, retinal abnormalities, cataract, glaucoma, retinoblastoma, eye muscle imbalance, and systemic disease with ocular manifestations may all be identified by careful examination. Vision screening should be carried out as part of a regular plan of continuing care, beginning in the preschool years. Screening examinations may be effectively performed by paramedical personnel under appropriate medical supervision. As with other specialty areas, it is important for the pediatrician to establish contact with an area ophthalmologist in the same geographical area who is familiar with children's eye problems. A close working relationship with such a specialist will clarify questions about procedures for eye screening as well as indications for referral. TIMING OF EXAMINATION AND SCREENING Children should have age-appropriate assessment for eye problems in the newborn period and at subsequent health supervision visits. Vision screening can begin as early as 3 years of age. Infants at risk for eye problems, such as retrolental fibroplasia, or those with a family history of congenital cataracts, retinoblastoma, and metabolic and genetic diseases should have an ophthalmologic examination in the nursery.

Download Full-text

School vision screening programmes in reducing uncorrected refractive error among children in Low and Middle-Income countries-LMIC (systematic review)

Advances in Ophthalmology & Visual System ◽

10.15406/aovs.2020.10.00392 ◽

2020 ◽

Vol 10 (4) ◽

pp. 91-105

Author(s):

Abraham Opare ◽

Leila H Abdullahi ◽

Deon Minnies ◽

Colin Cook ◽

Maylene Shung-King ◽

...

Keyword(s):

Academic Performance ◽

School Children ◽

Refractive Error ◽

Positive Impact ◽

Cost Effective ◽

Vision Screening ◽

Middle Income ◽

Middle Income Countries ◽

School Vision ◽

Uncorrected Refractive Error

ackground: The prevalence of uncorrected refractive error among school-age children is on the rise with detrimental effect on academic performance and socio-economic status of those affected. School vision screening programmes appear to be an effective way of identifying children with uncorrected refractive errors so early intervention can be made. Despite the increasing popularity of school vision screening programmes over the past few years, there is a lot of debate on its effectiveness in reducing the proportion of children with uncorrected refractive error in the long term, especially in settings where resources are limited. Some studies argue that school vision screening programmes are effective while other studies have reported otherwise. The purpose of this systematic review was to assess the effectiveness of school vision screening programmes in reducing uncorrected refractive error among children in low and middle income countries using evidence from published studies. Methods and findings: A comprehensive and systematic strategy was used to search various databases including PubMed, Cochrane Central Register of Controlled Trials (CENTRAL) which contains the Cochrane Eyes and vision Trial Register, the Cochrane Library, Medline (1980-2018), CINAHL, Academic Search Premier, Web of Science, the WHO’s Library Information System, Africa-Wide and Scopus. The search was restricted to articles published in English. Randomized control trials, cross-sectional studies, case-control studies and cohort studies were included in this review. Participants included school children with refractive error. Full-text review of search results, data extraction and risk of bias assessment was done by two independent reviewers. The certainty of the evidence was assessed using the GRADE approach and data were pooled using the random-effect model. Thirty studies met the inclusion criteria. This review found moderate certainty evidence indicating that school vision screenings may be effective in reducing uncorrected refractive error among school children by 81% (95% CI: 77%; 84%), 24% (95% CI: 13%; 35%) and 20% (95% CI: 18%; 22%) at two, six, and more than six months respectively after its introduction. Results: Results of this review also suggest that school vision screening may be effective in achieving 54% (95% CI: 25%; 100%), 57% (95% CI: 46%; 70%), 37% (95% CI: 26%; 52%), and 32% (95% CI: 14%; 72%) spectacle-wear compliance among school children at less than three months, at three months, at six months and at more than six months respectively after its introduction (low to moderate certainty evidence). This review further found moderate to high certainty evidence indicating that school vision screening, together with provision of spectacles, may be relatively cost effective, safe and has a positive impact on the academic performance of school children. Conclusion: The findings of this review show that school vision screening, together with provision of spectacles, may be a safe and cost-effective way of reducing the proportion of children with uncorrected refractive error, with long-term positive impact on academic performance of children. Most of the studies included in this review were, however, conducted in Asia. Research to investigate the effectiveness of school vision screening programmes in other parts of the world like Africa where few studies have been conducted is highly recommended

Download Full-text