Training Teachers on Vision Screening for School Children in Low-Resource Setting in Southwest, Nigeria

Background: There is a growing recognition that school teachers can be trained to deliver simple health and screening services and refer children for treatment if they have health problems. Although it is recognized that teachers are not replacement for qualified health personnel, they can be trained to provide simple vision screening for school children. Aim: This article aims to determine the ability of trained school teachers to participate in the school eye screening program by testing visual acuity (VA) of the primary and secondary school children aged 5 to 15 years using the Snellen’s chart in Ifo, Ifo Local Government Area of Ogun State. Materials and Methods: This study was a population-based descriptive cross-sectional study conducted among school children aged 5 to 15 years from 20 primary and secondary schools in Ifo, Ifo Local Government Area of Ogun State. Forty teachers (two per school) were trained to use the Snellen’s chart to measure VA and categorize vision into normal or impaired using the VA of 6/9 in the better eye as cutoff. After enumeration, the visual acuities of the school children were measured using the Snellen’s chart by the teachers and compared with visual acuities measured by the research team. Results: A total of 1308 school children (574 boys and 734 girls) had their VA tested using Snellen’s chart by 40 teachers and verified by the research team. The sensitivity of the teachers’ VA testing was 73.6%, with a high specificity of 93.8% and positive and negative predictive values of 45.7% and 98%, respectively. The teachers’ VA measurements showed a moderate agreement with that of the researchers with a Kappa score of 0.525. Conclusion: This study shows that school teachers can be trained to participate in school eye health program. Their involvement can make the program cheaper to establish, ensuring sustainable and better coverage among the targeted student population.