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Role of teachers in screening of ocular disorders in school children: A multistage school screening program

Purpose: The aim of the study was to find out whether teachers can be introduced as an effective tool in ocular screening of school children and to list out various causes of visual impairment and ocular abnormalities in school children and provide appropriate measures. Method: A multistage school screening program from August to December 2019 in Trivandrum included 33,990 students from 52 schools. Five stages of the study were training of selected teachers, screening by teachers in the school, comprehensive examination by the hospital team in schools, detailed evaluation of referred children in the hospital, and corrective measures by pediatric ophthalmologists in our hospital. A total of 1480 children were selected randomly from the children identified as normal by teachers to detect false negatives. The pattern of ocular disorders children was analyzed. Results: Out of 33,990 students, 6343 students who were detected to have ocular disorders by teachers (18.6%) were examined by our team. 74.2% (4707 students) of them were confirmed to have ocular problems. Thus teachers were able to identify the eye problems correctly (true positives) in 74.2% children, 25.8% being false positives. True positives include refractive errors (73.4%), allergic conjunctivitis (7.9%), strabismus (1.9%), amblyopia (0.098%), pediatric cataract (0.08%), etc. Out of 1480 randomly selected children, 8 (0.54%) children were false negatives (none had refractive errors). Spectacles were given to 2484 children free of cost. Conclusion: Simplicity of multistage screening, ease of its application, time and cost effectiveness, wider coverage, utility as a continuous process in coming years signifies that introducing teachers as primary vision screeners at their schools is an innovative community-based strategy to address the challenges of childhood blindness in resource-constrained settings.