1: Introduction to School Eye Health

Introduction

While data on children’s eye health is sparse, it is estimated that at least 450 million children have vision impairment, mostly due to refractive error ². Considering the significant impact of vision loss on health, education and productivity, an efficient school eye health programme can be a cost-effective investment for a nation to simultaneously improve health and education.

Comprehensive eye health services include provision of spectacles, but also identification and management of binocular vision and health conditions ³. In the past decades, many school eye health initiatives focused on refraction in children attending school, with referral of those with other eye conditions requiring additional eye care. However, vertical, isolated programmes focusing only on refraction are not sustainable and may have limited outcomes over time ^3,4. Integrated and comprehensive school eye health programmes are recommended approaches by the International Agency for Prevention of Blindness (IAPB) and the World Health Organization (WHO). These approaches have the potential to lead to better outcomes by involving not only the teachers and the children, but also the parents and the community ^3,5,6.

Key enabling factors for school eye health programmes (SEHP) include government ownership, collaboration with Health and Education ministries, coordination and integration with other school health programmes, community participation and standardisation ^5,6.

Need for school eye health

In 2020, the UN’s assembly voted for integrated people-centered eye care in universal health coverage objectives. Since this declaration and the publication of WHO’s Report of Vision in 2019,  access to eye care, including children’s eye health, has become a global priority.

• 90% of people living with visual impairment are from low-middle income countries, most of them having a preventable or treatable condition; Women, rural populations and ethnic minority groups are more likely to be affected ⁷
• Worldwide, vision impairment is responsible for annual productivity loss of approximately US$ 411 billion ¹.
• According to global estimates for 2020, 70.2 million children aged 0-14 years old were visually impaired, mostly from uncorrected refractive error ¹.
• Poor vision can have major impacts on a child’s education, personal development, self-esteem, social inclusion, and future economic productivity; Severe vision impairment can delay motor, language, emotional, social and cognitive development, with lifelong consequences ⁷
• Myopia prevalence has been increasing in the past decades due to urbanisation, reduced time spent outdoors and intensive educational practices ¹. By 2050, myopia is expected to affect more than half of the world’s population ⁸.