3: Screening guidelines

Introduction

Standardised protocols with uniform components is essential to monitor and compare outcomes of different programmes. However, it is important to consider available resources when designing a protocol. While comprehensive screenings are recommended, complex tests may be a limiting factor in some contexts⁵. Each approach has its pros and cons (see figure below) so a thorough situation analysis can help decide which model is feasible in each context. The following section presents a multi-stage protocol based on screeners and eye care professionals for detailed examination, but different protocols can be found in the literature, such as WHO Vision and Screening Implementation Handbook, the REACH programme³³ or WCO pediatric resource.

As mentioned previously, these guidelines represent minimum clinical guidelines for school eye health, with a focus on low- and middle-income countries. Where they exist, in-country formal and legal guidelines or protocols for school health or eye health should be considered and integrated.

Initial steps

• Meet with school directors, teachers and parents associations (if existing) for early sensitization
• Ensure child protection practices are in place and consent has been given for the screening to take place
• Find a quiet, private room with normal lighting; A waiting area should also be designated and supervised by a coordinator to prevent disorganization and distraction of children tested inside.
• Set-up material: Measure distance VA chart at testing distance (3 to 6 meters), prepare record charts
• Introduce the screening team and explain the testing procedures to all children (per class) to take away initial fears
• Screen one child at the time, the others waiting outside