Join us   Log in  

THE JOURNAL OF SCHOOL AND UNIVERSITY MEDICINE - Volume 7 Issue 1-2, January - June 2020

Pages: 12-17

Date of Publication: 20-Jun-2020

Print Article   Download XML  Download PDF


Author: Cristina Vladutiu, Simona Cainap, Oana Teodosescu, Raluca Maria Ursu, Simona Anca Sevan, Daniela Rajka, Mihai Mara

Category: Medical


INTRODUCTION: The aim of the study is to evaluate the background knowledge and attitude towards vision screening in health care professionals enrolled in EUSCREEN project (”Implementation of optimized childhood vision and hearing screening programmes in middle-income countries in Europe”).

METHOD: The analysis involved 178 questionnaires, filled out by family doctors and nurses who attended professional visual acuity training, organised at the beginning of EUSCREEN project. The courses took place at the University of Medicine and Pharmacy Cluj-Napoca, between October and November 2017.

RESULTS: Out of the 178 medical personnel, 132 (74.15%) had not participated in any other screening programme, whereas a further 44 persons (24.71%) had taken part in various screening programmes. Also, 115 (64.60%) of the medical staff who attended the training had not previously performed visual acuity testing in children.

Out of the 178 respondents, 176 (98.87%) consider that vision screening in children should be carried out in the general practitioners’ or school medical offices.

Main reasons for failing to obtain informed consent were: carelessness for a health issue/deficiency of health education (59), mistrust in the screening or medical staff (26), or parents' lack of time (24). Likely causes for failure of screening mentioned in the questionnaires were: poor collaboration with parents (67), lack of parents' consent (22) or compliance (18). Proposed solutions to raise compliance to screening were: efficient nurse-parent communication (47), explaining the importance of vision acuity testing in small children (58).

In the matter of remuneration of medical staff, 68% (122) consider it should be made in addition to the salary, meanwhile 26% (46) consider the screening activity as a compulsory duty of their job.

DISCUSSION: The respondents helped in predicting causes of failure to obtain the informed consent and failure in implementation of a visual screening programme, suggesting that lack of medical education and poor compliance would be the main causes; they also estimated that a good nurse-parent communication could be an efficient method of persuading the parents. The payment of the medical personnel involved in the screening was preferred by the respondents, but this remains a controversial topic.

CONCLUSIONS: A pediatric visual acuity screening programme in Romania is an achievable desideratum, but because of the lack of previous expertise in this field, it should be preceded by a thorough theoretical and practical training.

Probing the initial opinion, expectations and previous expertise of medical staff regarding screening programmes can provide with significant knowledge, required for the launch and progress of a visual screening program, and also facilitates evaluation of outcomes in the screening implementation study.

Keywords: visual acuity screening, debriefing session, amblyopia


.Braverman Rebecca S. Introduction to amblyopia. Am Acad Ophthalmol 2015

2.USPST Force, Grossman DC, Curry SJ, et al. Vision screening in children aged 6 months to 5 years: US preventive services task force recommendation statement JAMA, 318 (9) (2017), pp. 836-844

3.Shakarchi AF, Collins ME. Referral to community care from school-based eye care programs in the United States. Surv Ophthalmol (2019)

4.Wasserman RC, Croft CA, Brotherton SE. Preschool vision screening in pediatric practice: a study from the Pediatric Research in Office Settings (PROS) Network. Pediatrics. 1992;89(5 Pt 1):834–8

5.Marcinak JF, Yount SC. Evaluation of vision screening practices of Illinois pediatricians. Clin Pediatr. 1995;34:353–7.

6.Speechley M, Kunnilathu A, Aluckal E, Balakrishna MS, Mathew B, George EK. Screening in Public Health and Clinical Care: Similarities and Differences in Definitions, Types, and Aims – A Systematic Review [Internet].2017 March [Cited March1, 2020];11(3):LE01-LE04. Available from:

7.Chen AH, Abu Bakar NF, Arthur P. Comparison of the pediatric vision screening program in 18 countries across five continents. J of Curr Ophthalmology. 2019;31(4); 357-365

8.Buši? M, Bjeloš M, Petrove?ki M et al. Zagreb Amblyopia Preschool Screening Study: near and distance visual acuity testing increase the diagnostic accuracy of screening for amblyopia. Croat Med J. 2016; 57(1): 29–41.

9.Abu Bakar NF, Chen AH, Abdul Rahim MN, Goh PP. Pilot Study: A Review of Personnel Involved in School Vision Screening and the Training Module in Betong, Malaysia. Int Med J Malaysia. 2012;11(2);23-27.

10.Braverman, R. S. (2015). Pediatric vision screening: the Colorado school nurse experience. Journal of American Association for Pediatric Ophthalmology and Strabismus, 19(4), e20.

11.Cockburn J, Redman S, Hill D, Henry E. Public understanding of medical screening. J Med Screen. 1995;2(4):224-7.

12.Audit Commission. What seems to be the matter: communication between hospitals and patients. London: HMSO; 1993.

13.Coulter A. Evidence based patient information. BMJ. 1998;317:225–226.

14.Entwistle VA, Sheldon TA, Sowden A, Watt IS. Evidence-informed patient choice. Int J Technol Assess Health Care. 1998;14:212–215.

15.Austoker J, McPherson A. Cervical screening. Practical guides for general practice. 2nd ed. Oxford: OUP; 1992. Areas of uncertainty.

16.Austoker J. Gaining informed consent for screening is difficult—but many misconceptions need to be undone. BMJ. 1999 Sep 18; 319(7212): 722–723.