Effectiveness of school vision screening by teachers – a systematic review and meta-analysis

BACKGROUND: Visual impairment among school children is a prevalent concern that can affect their academic performance, intellectual, and interpersonal growth. Due to a lack of eye care professionals, school teachers were commonly involved in vision screening programs, and their effectiveness has been reported by a few studies with some methodological variations. Therefore, this systematic review aims to assess the effectiveness of teacher-led school vision screening programs in comparison with vision screening done by eyecare professionals. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standards were followed for conducting the review. MEDLINE, Scopus, and Web of Science were the databases used to search for original research articles using the keywords “vision screening,” “school children,” “teacher,” or related keywords. All quantitative studies were considered in this systematic review, while research articles involving a screening population greater than 18 years old were excluded. The meta-analysis was conducted utilizing the random effects model in the MetaDTA program. RESULTS: Based on the eligibility criteria, nine original research studies were taken into consideration for this systematic review. The summary receiver operating characteristics (SROC) curve analysis was performed. Two studies were excluded from the reanalysis due to poor sensitivity values and wider confidence intervals, indicating greater variability in sensitivity estimation. Pooled sensitivity and specificity of teacher conducted vision screening from seven studies were estimated to be 0.70 (95% CI [0.57, 0.80]) and 0.96 (95% CI [0.91, 0.98]), respectively. CONCLUSION: The results of this systematic review indicate that teacher conducted vision screening provides satisfactory results in comparison with vision screening done by eye care professionals. Therefore, school teachers can be a potential workforce for early identification of visual impairment and contribute to lowering the disease burden.