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Background: Success of a school vision screening program depends on compliance with the advice that is offered to the children. This study evaluates the effect of an intervention package on compliance to spectacle wear and referral in a school vision screening program.Methods: Among 8,442 children aged 13-17 years in 11 government schools in and around Chennai, India, 114 (2.2 per cent) children who required spectacles were allocated to the control arm (5,116 children) and 124 (3.7 per cent) children to the intervention arm (3,326 children). There were 44 (0.9 per cent) children in the control arm and 49 (1.5 per cent) children in the intervention arm who required referral for further management. Control schools received a conventional school screening protocol and intervention schools received 23-step interventions. Spectacle wear was noted in an unannounced direct observation after one, four and 12 months. Compliance to referral was noted based on the response of children with confirmation from medical records.Results: Spectacle compliance was significantly higher for the intervention arm compared to the control arm based on direct observation in the first month (17.6 per cent versus 49 per cent, adjusted odds ratio [OR] = 4.4, 95 per cent confidence interval [CI] 2.3-8.5, p < 0.05); in the fourth month (23 per cent versus 56 per cent, OR = 4.2, 95 per cent CI 2.3-7.8, p < 0.05); and in the 12th month (13.3 per cent versus 38.8 per cent, OR = 4.1, 95 per cent CI 1.8-9.4, p < 0.05). Referral compliance was significantly higher in the intervention arm in the first month (17.5 per cent versus 70.5 per cent, OR = 10.9, 95 per cent CI 3.8-30.9, p < 0.001) and in the fourth month (31.7 per cent versus 75.6 per cent, OR = 6.2, 95 per cent CI 2.3-16.0, p < 0.001).Conclusion: A 23-step package of interventions was effective in improving compliance to spectacle wear and referral among adolescents in a school vision screening program. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to report the minimum test battery needed to screen non-strabismic binocular vision anomalies (NSBVAs) in a community set-up. When large numbers are to be screened we aim to identify the most useful test battery when there is no opportunity for a more comprehensive and time-consuming clinical examination.Methods: The prevalence estimates and normative data for binocular vision parameters were estimated from the Binocular Vision Anomalies and Normative Data (BAND) study, following which cut-off estimates and receiver operating characteristic curves to identify the minimum test battery have been plotted. In the receiver operating characteristic phase of the study, children between nine and 17 years of age were screened in two schools in the rural arm using the minimum test battery, and the prevalence estimates with the minimum test battery were found.Results: Receiver operating characteristic analyses revealed that near point of convergence with penlight and red filter (> 7.5 cm), monocular accommodative facility (< 10 cycles per minute), and the difference between near and distance phoria (> 1.25 prism dioptres) were significant factors with cut-off values for best sensitivity and specificity. This minimum test battery was applied to a cohort of 305 children. The mean (standard deviation) age of the subjects was 12.7 (two) years with 121 males and 184 females. Using the minimum battery of tests obtained through the receiver operating characteristic analyses, the prevalence of NSBVAs was found to be 26 per cent. Near point of convergence with penlight and red filter > 10 cm was found to have the highest sensitivity (80 per cent) and specificity (73 per cent) for the diagnosis of convergence insufficiency. For the diagnosis of accommodative infacility, monocular accommodative facility with a cut-off of less than seven cycles per minute was the best predictor for screening (92 per cent sensitivity and 90 per cent specificity).Conclusion: The minimum test battery of near point of convergence with penlight and red filter, difference between distance and near phoria, and monocular accommodative facility yield good sensitivity and specificity for diagnosis of NSBVAs in a community set-up. [ABSTRACT FROM AUTHOR]

Background: To determine the spectacle reassessment rates of dissatisfied patients returning to the optical services department of a tertiary eye centre in India over a period of six years.Methods: A total of 169,567 spectacles were dispensed from the optical services department between January 2010 and December 2015. The spectacle reassessment forms of dissatisfied patients who returned to the optical services department with their spectacles were analysed.Results: A total of 797 spectacle reassessment forms were analysed. The overall spectacle reassessment rate during the study period was found to be 0.5% (95% CI: 0.467-0.472). The mean age of patients returning back for spectacle reassessment was 48 years (SD 19.9, range 3-97 years). Error in refractive correction measurement was found to be the most common reason for spectacle reassessment (54.7%), followed by dispensing error (21.1%), documentation errors while writing the prescription from the medical records in the tertiary eye care centre (12.7%), transcription error occurring at the optical services department (10.8%) and ocular pathologies (0.8%). No statistically significant difference was observed in the year-wise spectacle reassessment rates during the study period (p = 0.14).Conclusions: The frequency of spectacle reassessment rate in a tertiary eye care centre was low, with errors in measuring refractive errors contributing the most to the reassessment and reorder of spectacles. [ABSTRACT FROM AUTHOR]