Strategies to Improve the Accuracy of Vision Measurement by Teachers in Rural Chinese Secondary Schoolchildren

Sharma, Abhishek; Li, Liping; Song, Yijun; Choi, Kai Chow; Lam, Dennis S.C.; Zhang, Mingzhi; Zheng, Mingwei; Zhou, Zhongxia; Liu, Xiaojian; Wu, Bin; Congdon, Nathan

doi:10.1001/archopht.126.10.1434

Cited by 33 publications

(39 citation statements)

References 37 publications

(46 reference statements)

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“…However, our final number of trained teachers was within the range reported in other programs (11, 14) and remains sufficiently large to draw conclusions as expected in a pilot intervention.…”

Section: Discussionsupporting

confidence: 69%

Reducing visual deficits caused by refractive errors in school and preschool children: results of a pilot school program in the Andean region of Apurimac, Peru

Latorre-Arteaga

Gil‐González

Enciso³

et al. 2014

Global Health Action

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BackgroundRefractive error is defined as the inability of the eye to bring parallel rays of light into focus on the retina, resulting in nearsightedness (myopia), farsightedness (Hyperopia) or astigmatism. Uncorrected refractive error in children is associated with increased morbidity and reduced educational opportunities. Vision screening (VS) is a method for identifying children with visual impairment or eye conditions likely to lead to visual impairment.ObjectiveTo analyze the utility of vision screening conducted by teachers and to contribute to a better estimation of the prevalence of childhood refractive errors in Apurimac, Peru.DesignA pilot vision screening program in preschool (Group I) and elementary school children (Group II) was conducted with the participation of 26 trained teachers. Children whose visual acuity was<6/9 [20/30] (Group I) and≤6/9 (Group II) in one or both eyes, measured with the Snellen Tumbling E chart at 6 m, were referred for a comprehensive eye exam. Specificity and positive predictive value to detect refractive error were calculated against clinical examination. Program assessment with participants was conducted to evaluate outcomes and procedures.ResultsA total sample of 364 children aged 3–11 were screened; 45 children were examined at Centro Oftalmológico Monseñor Enrique Pelach (COMEP) Eye Hospital. Prevalence of refractive error was 6.2% (Group I) and 6.9% (Group II); specificity of teacher vision screening was 95.8% and 93.0%, while positive predictive value was 59.1% and 47.8% for each group, respectively. Aspects highlighted to improve the program included extending training, increasing parental involvement, and helping referred children to attend the hospital.ConclusionPrevalence of refractive error in children is significant in the region. Vision screening performed by trained teachers is a valid intervention for early detection of refractive error, including screening of preschool children. Program sustainability and improvements in education and quality of life resulting from childhood vision screening require further research.

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Section: Discussionsupporting

confidence: 69%

Reducing visual deficits caused by refractive errors in school and preschool children: results of a pilot school program in the Andean region of Apurimac, Peru

Latorre-Arteaga

Gil‐González

Enciso³

et al. 2014

Global Health Action

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“…For example, Sharma et al (2008) has shown that after a brief training session from a clinician, teachers can successfully and accurately take on the burden of screening children for vision problems in their classes or schools, and refer non-passing children to specialists in the county seat for further examination. Sharing the screening burden with teachers based locally nearly eliminates the need for clinicians to travel to distant schools to provide this first level of care.…”

Section: Resultsmentioning

confidence: 99%

Poor Vision Among China's Rural Primary School Students: Prevalence, Correlates and Consequences

Zhang

et al. 2017

SSRN Journal

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Using a survey of 19,977 children in two provinces, this paper explores the prevalence, correlates and potential consequences of poor vision among children in China's vast but understudied rural areas. We find that 24% of sample students suffer from reduced uncorrected visual acuity in either eye and 16% in both eyes. Poor vision is significantly correlated with individual, parental and family characteristics, with modest magnitudes for all correlates but home province and grade level. The results also suggest a possible adverse impact of poor vision on academic performance and mental health, particularly among students with severe poor vision.

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“…In Iran, for instance, the sensitivity and specificity of teachers' screenings are 37.5% and 92% (at the 20/25 cut-off); in China, the rates are 93.5% and 91.2% (at the 6/12 or 20/40 cut-offs); and in Tanzania, the rates are 80% and 91% (at the 6/12 or 20/40 cut-offs) [4], [23], [24]. No other study, however, has examined teacher-conducted screening in pre-primary school children; this is the first study evaluating the feasibility and accuracy of non-health professionals screening for refractive errors in this population group.…”

Section: Discussionmentioning

confidence: 99%

Assessing the Accuracy and Feasibility of a Refractive Error Screening Program Conducted by School Teachers in Pre-Primary and Primary Schools in Thailand

et al. 2014

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IntroductionAs part of the development of a system for the screening of refractive error in Thai children, this study describes the accuracy and feasibility of establishing a program conducted by teachers.ObjectiveTo assess the accuracy and feasibility of screening by teachers.MethodsA cross-sectional descriptive and analytical study was conducted in 17 schools in four provinces representing four geographic regions in Thailand. A two-staged cluster sampling was employed to compare the detection rate of refractive error among eligible students between trained teachers and health professionals. Serial focus group discussions were held for teachers and parents in order to understand their attitude towards refractive error screening at schools and the potential success factors and barriers.ResultsThe detection rate of refractive error screening by teachers among pre-primary school children is relatively low (21%) for mild visual impairment but higher for moderate visual impairment (44%). The detection rate for primary school children is high for both levels of visual impairment (52% for mild and 74% for moderate). The focus group discussions reveal that both teachers and parents would benefit from further education regarding refractive errors and that the vast majority of teachers are willing to conduct a school-based screening program.ConclusionRefractive error screening by health professionals in pre-primary and primary school children is not currently implemented in Thailand due to resource limitations. However, evidence suggests that a refractive error screening program conducted in schools by teachers in the country is reasonable and feasible because the detection and treatment of refractive error in very young generations is important and the screening program can be implemented and conducted with relatively low costs.

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Strategies to Improve the Accuracy of Vision Measurement by Teachers in Rural Chinese Secondary Schoolchildren

Cited by 33 publications

References 37 publications

Reducing visual deficits caused by refractive errors in school and preschool children: results of a pilot school program in the Andean region of Apurimac, Peru

Reducing visual deficits caused by refractive errors in school and preschool children: results of a pilot school program in the Andean region of Apurimac, Peru

Poor Vision Among China's Rural Primary School Students: Prevalence, Correlates and Consequences

Assessing the Accuracy and Feasibility of a Refractive Error Screening Program Conducted by School Teachers in Pre-Primary and Primary Schools in Thailand

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