Date post: | 15-Aug-2015 |
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The National Screening Program for Refractive Errors in Kindergarten Children in The State of Kuwait
Dr. Khalid Al AneziMRCGP (int.)Head of Jahra School Health Division State of Kuwait
Introduction
• The National Screening Program for Refractive Errors in Kindergarten Children in The State of Kuwait is initiated by both school health administration and the Ophthalmology departments Counsel , Kuwait MOH.• This program aims for the Early Detection of RE
in KG children & Prevention of visual disability.
Introduction
• These conditions could hinder the child ‘s academic performance , social interaction , and cognitive functioning.
• Prevalence in school age children : 12%• Joint Responsibility. (SH – School – Family)• Cost-Effective.• EBM.
Refractive errors
• Refractive errors are abnormalities in the way light from a distant object is focused - via convergence of rays at the convex cornea and lens - onto the retina.
• Common at any stage of childhood.
• Treatment of refractive errors is with spectacles , to improve visual acuity and prevent blindness.
• Commonest cause of blindness in childhood & Adolescence.
Goals
• Early Detection of Refractive errors.• Prevention of complications & Visual Disability.• Estimation of possible Risk factors for RE &
Visual Health.
Methodology
• An estimation of the Total Population of KG1 Children with RE in all schools (Governmental & Private) in the State of Kuwait.
• Our target Age group is : 4-5 years old.
Methodology
Timeline : Preparation : March 2013 – August 2013EBM Joint meetings with ophthalmology Dept.,Development of Clinical practice protocols Staff training Population estimationMass Media (Audiovisual , Printed , social M.)
MethodologyGovernorate No. of KG
School (Gov.)
No. of KGSchool(Private)
No. of KG 1Students
No. of Nursing Staff
No. of School Health Physicians
Ahmadi 39 18 8462 39 6
Jahra 31 5 3991 31 5
Hawalli 27 52 6241 27 7
Capital 28 4 3000 28 4
Farwania 39 27 10630 39 5
Mubarak K. 34 - 2000 34 4
Total 198 106 34324 198 31
Methodology
Examination Technique :Snellen chart was used in a distance of 6 m. and 1.5-2 m. height ,
pointers were used.Room with adequate natural and artificial lightening with no
reflective surfaces.Quiet Environment.Adequate explanation for school staff , toys .Disposable Eye pad. (right then left).Standing sign.Repetition of the exam by the school nurse in case of uncooperative
child or positive result.Children with glasses were included.
Methodology
Examination Technique :Recording of result was done in the Student Health File & The
Screening Program Registry.Follow up examination after 1 month for positive cases , and after 6
months for negative cases.
Tools
1- Guardian Consent Form and Risk factors Questionnaire:A medico legal consent form is distributed to the
guardians of the child to allow the visual assessment by the nurse , if the guardian agrees , a questionnaire contains the following :
possible Risk factors to visual acuity.Whether the Child weirs spectacles or notWhether previous ophthalmological procedure was
done for the child or not.The Academic Qualifications for both parents /Guardians
:(University/College , High school , below High School)
Toolspossible Risk factors to visual acuity include :
No. of Hours per day of :ReadingWritingDrawingUsing Devices with Screens (Computers , Tablets , Smart phones , Video Games).
Tools2- The School Clinic Registry :
StudentName
Civil IDNumber
ContactTel.
The Result Referral FeedbackReport
Recommendations
With Glasses
W/OGlasses
Rt. Lt. Rt. Lt.
Results
Province
Total NO. of Children
NO. of Children examined
No. of Children referred
Absentees &Refusal
% of Examined
Ahmadi 8462 4997 88 3465 59%
Jahra 3991 3281 67 710 82%
Hawalli 6241 5492 113 749 88%
Capital 3000 2480 136 520 83%
Farwania
10630 5422 106 5208 51%
Mubarak K.
2000 1440 102 560 72%
Total 34324 23112 612 11212 67%
Barriers
• Shortage of staff• Constant absence of children• Refusal (Children / Parents)• Lack of feedback.• Overcrowded 2ry point of care.