Sensitivity and specificity of teachers for vision screening among primary school children in South India.

AIMS

This study aims to determine the sensitivity and specificity of vision screening by school teachers among primary school children.

SETTINGS AND DESIGN

Prospective nonrandomized clinical trial.

SUBJECTS AND METHODS

The study was carried in primary school children of Madurai, Tamil Nadu from April 2007 to October 2007. Sixty-five primary school teachers from 57 schools around Madurai, Tamil Nadu, India, underwent a half-day training programme at the hospital. Each teacher on return to the school screened around a hundred children using the tumbling E. All screened children were subsequently screened by a team from the hospital. The optometrists used tumbling E (Snellen's 20/30 and Early Treatment of Diabetic Retinopathy Study (ETDRS) 20/32) to check the vision of all children. Any child complaining of defective vision or noted to have defective vision on screening underwent a comprehensive ophthalmic evaluation. The sensitivity and specificity of teacher screening was assessed based on the data obtained.

RESULTS

Screening was completed for 5150 children. The prevalence of vision <20/30 was 2.82%. Teacher screening was noted to have a sensitivity of 24.8% and a specificity of 98.65%. Tumbling E ETDRS screening by the optometrist had the highest sensitivity of 94.48% and specificity of 97.09%.

CONCLUSIONS

Our study shows that vision screening by trained optometrists is a very useful tool to identify visual impairment in primary school children. Measures need to be taken to improve the sensitivity of teacher screening before recommending its generalized use.