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Evaluation of ′vision screening′ program for three to six-year-old children in the Republic of Iran

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Author(s): Khandekar Rajiv | Parast Noa | Arabi Ashraf

Journal: Indian Journal of Ophthalmology
ISSN 0301-4738

Volume: 57;
Issue: 6;
Start page: 437;
Date: 2009;
Original page

Keywords: Amblyopia | childhood blindness | evaluation | Iran | vision screening

ABSTRACT
Background : Since 1996, vision screening of three to six-year-old children is conducted every year in Iran. We present outcomes of project review held in August 2006. Materials and Methods : Kindergarten teachers examined vision by using Snellen′s illiterate ′E′ chart. They used torchlight to detect strabismus. On a repeat test, if either eye had vision < 20/30, the child was referred to the optometrist. A pediatric ophthalmologist examined and managed children with strabismus or amblyopia. Provincial managers supervised the screening program. The evaluator team assessed the coverage, yield, quality and feasibility, and cost-effectiveness of vision screening, as well as magnitude of amblyopia, and its risk factors. Result : In 2005, 1.4 million (67%) children were examined in all provinces of Iran. Opticians examined 90,319 (61%) children with defective vision that were referred to them. The prevalence of uncorrected refractive error, strabismus and amblyopia was 3.82% (95% CI 3.79 - 3.85), 0.39% (95% CI 0.38 - 0.40) and 1.25% (95% CI 1.24 - 1.26) respectively. Validity test of 7,768 children had a sensitivity of 74.5% (95% CI 72.7 - 76.3) and specificity of 97.2% (95% CI 96.7 - 97.7). The cost of amblyopia screening was US $ 1.5 per child. While the cost of screening and treating one child with amblyopia was US $ 245. Conclusion : A review of the vision screening of children in Iran showed it with screening and useful exercise and had a yield of 1:21. The coverage of vision screening was low and the management of children with amblyopia, low vision and refractive error needed strengthening.
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