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New research · Ophthalmology
Kathmandu University medical journal (KUMJ) · 23h
Randomized trialKathmandu University medical journal (KUMJ) · 2025

Visual Acuity Screening By by School Teachers in Far West Nepal: A randomized trial of alternate screening models.

S Awasthi, P A Reddy, K L Bassett
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OphthalmologyRandomized trial

Screening by all classroom teachers found vision problems more accurately than by selected teachers.

Visual Acuity Screening By by School Teachers in Far West Nepal: A randomized trial of alternate screening models.

S Awasthi … K L Bassett
Kathmandu University medical journal (KUMJ) · 2025
Background

Studies have not examined alternate school visual acuity screening methods in Nepal in terms of accuracy and cost.

Purpose

To validate recent evidence from India of the effectiveness and cost of alternate school visual acuity screening models involving all class teachers (all class teachers) versus a few selected teachers (selected teachers).

Methods

This was a prospective cluster randomized controlled study.

n = 3713 children
Results

all-teacher screening correctly caught 95.1% of true vision problems

95.1%
Sensitivity
92.8%
Specificity
More results

The sample size was 5000 students.

Teachers from both arms were trained to identify children aged 6 years and above with Snellen visual acuity 6/9 or worse in either eye as well as obvious ocular abnormalities and refer them to an ophthalmic team.

More results

Result All class teachers (80 teachers) screened 3713 children and selected teachers (9 teachers) screened 2064 children aged 6 to 15 years.

The cost of screening per child with refractive error and or other ocular abnormalities was $3.05 for all class teachers and $ 5.29 for selected teachers.

“
Conclusion

A school vision screening involving all class teachers in Nepal was more accurate than selected teachers in identifying refractive error and or other ocular abnormalities at approximately 60% of the cost.

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