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Screening of vision in school: could we do better by doing less?
1Department of Community Medicine, Southmead Hospital, Bristol.
BMJ (Clinical Research Ed.)
|October 29, 1988
Summary
School vision screening programs in England and Wales showed significant variability in methods and effectiveness. Many districts screened intensively, but lacked data for monitoring and used unsuitable locations, questioning overall program efficiency.
Area of Science:
- Ophthalmology
- Public Health
- Pediatrics
Background:
- Vision screening in schoolchildren is a routine practice.
- The effectiveness of these established screening programs has not been comprehensively reviewed.
- Variations in screening protocols and implementation exist across different health districts.
Purpose of the Study:
- To assess the current practices and effectiveness of vision screening programs in schools across England and Wales.
- To identify variations in screening methodologies, frequency, and referral criteria.
- To evaluate the adequacy of data collection for program monitoring.
Main Methods:
- A survey was conducted among health districts in England and Wales at the end of 1984.
- Response rate from districts was 81% (165 districts responded).
- Data collected included types of vision tests performed, screening frequency, referral criteria, and data monitoring practices.
Main Results:
- All responding districts screened for loss of distant visual acuity; 96% screened for color vision, 73% for squint, and 67% for loss of near visual acuity.
- Screening frequency and methods varied considerably among districts.
- Many screenings occurred in unsuitable locations, referral criteria were inconsistent, and data for monitoring was rarely collected.
- Screening intensity often exceeded justification based on tested conditions and potential treatment benefits.
Conclusions:
- Significant inconsistencies and inefficiencies were found in school vision screening programs.
- Lack of standardized protocols, appropriate facilities, and data collection hinders effective program evaluation.
- Recommendations for improved standardization and evidence-based practices are warranted to enhance the effectiveness of vision screening in schoolchildren.