AIM:

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.

MATERIALS AND 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.

Abstract

This study was conducted to determine awareness and practices relating to diabetic retinopathy among non-medical persons in a south Indian population. In this population-based cross-sectional study, trained social workers conducted face-to-face interviews using a semi-structured questionnaire with 200 randomly selected paramedical personnel and 204 persons randomly selected from the community. Responses were graded on a five-point scale.

Over half of respondents were not aware of risk factors for diabetic retinopathy. Only one-fifth of paramedics and one-tenth of persons from the community were aware that uncontrolled diabetes was a risk factor for retinopathy. Over 75% of respondents were not aware of either laser or surgery as an intervention for retinopathy. Although 80% of respondents from the community felt that yearly eye examinations were essential, only 43.5% had ever visited an ophthalmologist. Nearly three-fourths of paramedical personnel did not have any material related to diabetes for health education. It is evident that considerable effort is required to improve awareness of diabetic retinopathy, and to translate this improved awareness to actual utilisation of services.