Enhanced school-based vision screening in Kumasi, Ghana: a pilot study to assess feasibility

Abstract Background: Childhood vision loss is a public health concern in Ghana, where access to eye care is limited. This study aimed to examine the feasibility of an enhanced, school-based vision screening protocol amongst children enrolled in a private and public school in Kumasi, Ghana. Methods: Prospective cohort pilot study. In November-December 2024, optometrists used an enhanced vision screening protocol to screen for ocular disorders. Children were aged 4 to 22 in US grade 1- 9 equivalent classrooms. Children identified with significant ocular disorders using established criteria, were referred offsite to an eye clinic for a comprehensive eye examination. The main outcome measures were pparticipation in vision screening (proportion of school children screened), prevalence of ocular disorders, referral adherence. Adherence to referrals was assessed using caregiver questionnaires, reports from referring optometrists, and interviews with children. Descriptive statistics and regression models were used to describe outcomes and differences by school type Results: Out of 2,150 children attending both schools, 1,152 (53.6%) consented and completed screening. Complete data for 1,123 (97.5%) children was analyzed; 437 (38.9%) attended public and 686 (61.1%) private school. The average age of children screened was 10.2 (±2.6) years. The prevalence of ocular disorders was 34.0% (n=382). Referral adherence was assessed for 299 children, of which 98 (32.8%) adhered to the referral. Conclusion: Half of eligible children participated in the school-based vision screening program, a third were identified with untreated ocular disorders, and a third adhered to referral. Enhanced school-based vision screening could be a feasible strategy to identify untreated ocular disorders among school children in Kumasi, Ghana, however strategies to improve participation, and referral adherence are needed.