Abstract
Background: Vision screenings are important in identifying visual anomalies likely to disrupt
the physical, intellectual, social and emotional development of children. School health services
globally include vision screenings, complementing a variety of associated screening services.
Aim: This review article provides evidence for content, provision and efficacy of the vision
screening services for children of school-going age and reports on the current practice of
children’s vision screenings worldwide including in South Africa.
Methods: Studies were identified from PubMed, Ebscohost and Science Direct with the search
terms utilised during the selection of electronic articles and journals for the review. The target
population includes children of school-going age from 6 to 19 years without previously known
conditions associated with visual anomalies and learning-related problems. The quality of
vision screening programmes and policies for the school-going age children in different
countries were evaluated using Wilson and Jungner criteria.1
Results: Vision screening programmes worldwide appear to support comprehensive vision
screening methods among pre-schoolers (from birth to ≤ 6 years vs. children of school-going
age). The development of vision screening procedures in some countries in the United States
of America (USA) was found to be grounded on epidemiologic findings and principles. These
may have contributed towards the formulation of national vision screening guidelines for preschoolers
that supported the detection of amblyopia and its associated conditions such as
strabismus, anisometropia and myopia. School-going children’s vision screenings are not
supported worldwide as research has shown that there is lack of benefits for detecting other
visual anomalies such as vergence and accommodative dysfunctions. This is despite evidence
provided by the literature reviewed that an association exists between prevalent accommodation
and vergence dysfunctions including poor ocular motilities and poor near-vision, among
children of school-going age with poor academic performance.
Conclusion: The guidelines worldwide support school vision screenings, especially for the
pre-schoolers by the school health nurses, with other programs having considered the teachers,
optometrists or orthoptists as the appropriate personnel to conduct the school vision
screenings. There is still a need for the effectiveness of the school vision-screening programmes
to be investigated related to the importance of detecting convergence and accommodative
dysfunctions for the school going age children.