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After Cataract, Refractive Error (RE) is the second largest cause of avoidable blindness, particularly among the school going children. To tackle this important component of avoidable blindness, school children of all age group need to be examined periodically as a routine measure. Apart from Refractive Error, presence of other ocular diseases commonly affecting children like squint, amblyopia, congenital defects in one or both eyes, miscellaneous causes of low vision, vitamin A deficiency causing dryness of eye, infections like trachoma that can compromise corneal clarity in the long run, also need to be identified and treated before it is too late. 

Children usually don't complain of defective vision especially if only one eye is involved. They may not even be aware of their problem. They adjust to the poor eyesight by sitting near the blackboard,holding the book closer to their eyes, squeezing the eyes and even avoiding work requiring visual concentration. This evades early detection. Timely detection of these problems and their correction by spectacles can tremendously improve the child's potential during his formative years. Visual impairment is an avoidable burden in the life of a child, his family and the society. Periodic screening of all children helps in early identification of visual defects and correction of REs, by prescription/use of corrective spectacles.

Therefore, vision screening and complete eye examination of children is an all-important activity.

A medical team lead by an Ophthalmologist, duly assisted by optometrist and paramedic staff, shall visit every school and conduct eye screening of every student. Glasses will be prescribed to students to correct refractive errors. Parents of students in private schools can afford spectacles. For students in government schools, we propose to provide free spectacles. From our experience, we have noticed that roughly 20% of children screened require spectacles. Approximately 3,000 spectacles will be needed. For students requiring other types of therapeutic services or vision aids like low vision devices will be referred to vision centres. Cases requiring surgical intervention shall be referred to nearest available hospital. In case of Government Schools, a list of students requiring low vision devices or surgical intervention can be forwarded to the District Sarva Siksha Mission. A detail report comprising of student names identified with eye defects, nature of problem identified and recommended corrective measure shall be provided to the Principal of the school and the concerned class teacher for regular follow-up. For purpose of serving referral patients, our tie-up with Sankar Netralaya will be an additional advantage for students identified by Turnstone Global to require such services.

After screening by medical team in school, our community worker will follow-up with respective school periodically to ensure that the recommended measures are being followed properly.

Matrices for measuring intended benefits:

In order to measure the intended benefits of the Eye Screening Project in Schools, various tangible quantitative indicators shall be used. These indicators will encompass data to provide information about the community as well as services offered by the project.

MEASURING INDICATORS FOR THE PROPOSED PROJECT

Quantitative Indicator 1: Total number of students screened in schools.

Quantitative Indicator 2: Total number of refraction done and glasses dispensed.

Quantitative Indicator 3: Total number of low vision cases identified in schools.

Quantitative Indicator 4: Total number of surgical cases identified and referred to hospitals

Quantitative Indicator 5: Total number of students identified other than RE, LV and surgical intervention like Glaucoma, Squint, etc. Congenital Cataract etc.

Quantitative Indicator 6 : Total number of students provided glasses and use them regularly

Quantitative Indicator 7: Any other special observation