Accuracy of Vision Screening for Elementary School Students by Teachers in School-Based Setting

Introduction: Due to limitations in healthcare resources, teachers are hoped to conduct vision screening effectively at school. Objective: To determine the accuracy of vision screening conducted by teachers compared to those conducted by practitioners. Methodology: Seventy five teachers from two elementary schools in East Java Province, Indonesia, were trained to screen their fourth to sixth grade students. They were trained to use six tumbling E-letters arranged in a row, self-printed in different orientations, and held three meters away. Identifying of at least four optotypes correctly was considered as “pass”, and the letter size was set represent 6/9 Snellen visual acuity. The practitioners then repeated the examination using a standardized Snellen chart. The results from both groups were then compared and analyzed statistically. Results: A total of 918 eyes from 459 students were evaluated in this study. Although there was a statistically significant difference between the results of the teachers’ screening and the practitioners’ (p<0.05), the teachers still demonstrated good clinical accuracy. Specifically, the teachers’ screening showed an accuracy of 84.85% per eye and 84.05% per student compared to the practitioner’s assessment. Discussion: The results were not 100% accurate, which may be due to inadequate training, a lack of proficiency among the teachers, and unsuitable environmental conditions during the screenings. Nevertheless, an accuracy rate of 84% is still considered good. Conclusion: Vision screening conducted by teachers is an accurate method for the early detection of vision disorders and could be considered a national strategy to prevent avoidable blindness.