A Vision Screening to Address Refractive Error of Primary School Students in a School of Bangkok Metropolitan Province

Abstract

          Abnormal vision affects student learning and should be addressed early in the educational process. This research aimed to assess vision screening practices and suggest guidelines to address refractive error in grade 5 students by studying students attending Anubansamsen School, Bangkok. The researcher collected data from health examination forms and performed an assessment of visual acuity (VA). The data was collected from May to December 2013. Of 143 students who participated in this study, 69 were boys (48.3%) and 74 were girls (51.7%). The outcome was compared with previous screening data when students were in grade 1 (2009), and grade 3 (2011). The tools of this study were a Snellen chart or an Allen card and an Occluder, to identify refractive error. Outcomes were divided into three categories: normal vision (20/20 visual acuity), mild visual impairment (20/30 visual acuity), and poor vision (≤20/40 visual acuity). 107 students (74.8%) had normal vision, 11 students (7.7%) had mild visual impairment and 25 students (17.5 %) had poor vision.

          Reviewing data over the last five years showed that the vision of the 107 students (88.4%) who had normal vision at grade 1 was not changed. On the other hand, the vision of the 6 students (46.2%) with mild visual impairment and the 9 students (100%) with poor vision had deteriorated. In addition, new cases with poor vision were reported at each screening visit. For example, in 2009, 2011, and 2013, 9 students (6.3%) in grade 1, 6 students (4.2%) in grade 3, and 10 students (7%) in grade 5 had poor vision.

            In summary, this study demonstrated that refractive error in school-aged children is a common problem and tends to increase over the years. As a result, students who have vision problems should be referred with regular follow-up. Following the guideline for preventive health care by the Royal College of Pediatricians of Thailand, the outcome of this study, it is suggested that school-aged children have vision checks at least every two years. This eye screening guideline should be incorporated into public school nurses’ usual workload.