John Deepika Dorothy, Paul Padma, Kujur Evon Selina, David Sarada, Jasper Smitha, Muliyil Jayaprakash
Postgraduate Registrar, Department of Ophthalmology, CMCVellore, Tamil Nadu, India.
Associate Professor, Department of Ophthalmology, CMC, Vellore, Tamil Nadu, India.
J Clin Diagn Res. 2017 Aug;11(8):NC16-NC19. doi: 10.7860/JCDR/2017/25388.10476. Epub 2017 Aug 1.
Avoidable blindness is mainly due to uncorrected refractive errors (URE). School Eye Screening (SES) can be used as an initiative to address this issue.
To determine prevalence of URE and Number Needed to Screen (NNS) to find one child with low vision or blindness from URE among rural school children.
A cross-sectional study was performed in 22 government schools with sixth to ninth grades in Kaniyambadi block of Vellore District of Tamil Nadu, India. There were 4739 children on the rolls. Among children present, all those identified to have a visual deficit in either eye, using a single line 20/40 Snellen's optotype E chart at 6 m, were referred to the hospital for confirmatory evaluation. Blindness (uncorrected) was defined as inability to see 20/200 in the better eye. In two of these schools, visual deficits were validated through a second school based examination by a clinician.
Of the 4739 children on rolls, 601 were absent; all 4138 (87.3%) who were present underwent screening; 2.3% (98) {95% Confidence Interval (CI) 1.8 to 2.8} failed the screening test in at least one eye and were referred for examination. Only 28 (28.6%) of 98 children who were referred came for examination to the hospital. In the 2 of the 22 schools where the visual deficit was validated, there were no false positives. The prevalence of refractive error in these two schools was 2.2% (95% CI 1.7 - 2.7). NNS to detect one child with low vision or blindness from URE was 147.
Magnitude of refractive error, low NNS, low response to referral necessitates complete care at school and hence a relook at the current SES program.
可避免的失明主要归因于未矫正的屈光不正（URE）。学校视力筛查（SES）可作为解决这一问题的一项举措。
确定农村在校儿童中URE的患病率以及筛查出一名因URE导致视力低下或失明儿童所需的筛查人数（NNS）。
在印度泰米尔纳德邦韦洛尔区卡尼亚姆巴迪街区的22所六年级至九年级的政府学校开展了一项横断面研究。登记在册的儿童有4739名。在到场的儿童中，所有使用单排20/40斯内伦E型视力表在6米处检查发现单眼有视力缺陷的儿童，均被转诊至医院进行确诊评估。失明（未矫正）定义为较好眼视力无法达到20/200。在其中两所学校，由一名临床医生通过第二次校内检查对视力缺陷进行了验证。
在登记在册的4739名儿童中，601名缺勤；到场的4138名（87.3%）儿童均接受了筛查；2.3%（98名）{95%置信区间（CI）1.8至2.8}至少一只眼筛查未通过并被转诊检查。98名被转诊的儿童中只有28名（28.6%）到医院接受了检查。在22所学校中对视力缺陷进行验证的2所学校里，没有假阳性情况。这两所学校屈光不正的患病率为2.2%（95%CI 1.7 - 2.7）。筛查出一名因URE导致视力低下或失明儿童的NNS为147。
屈光不正的严重程度、低NNS以及对转诊的低响应率表明在校需要提供全面护理，因此有必要重新审视当前的SES项目。
