Evaluation of the Vision Screening in School Children, Hamadan Province, West of Iran

Background: Despite the fact that school nurses perform visual screening of pupils in Iranian primary schools; very few studies have been done to determine the validity of the screening test. This study was conducted to assess the validity of visual screening test by school nurse compare to optometrist diagnosis. Methods: A total of 878 pupils aged 6-15 year were studied. A school nurse performed screening for visual ability using E-chart. Also all the pupils referred to an optometrist for definite diagnosis. Then the results obtained by the school nurse were compared to the optometrist diagnosis. In comparison, the sensitivity and specificity of the test were calculated to show the value of the screening test. Results: From all the pupils, who were screened by the school nurse, 64 screened out positively. These pupils were referred to the optometrist, 87.5% were diagnosed as having vision disorders. 91.5% of the other pupils, who were screened out negative and referred to the optometrist, were healthy. Comparison of the results of the vision screening with the outcome of a full eye examination, gave a sensitivity and specificity of 44.8% and 98.9% respectively. Conclusion: The use of E-chart by school nurse to determine visual "defects" of school children, is low sensitive but highly specific. To improve the present system of visual screening in the schools, training of the school nurses is recommended.