Today’s article topic is – Innovative eye care screening! This is the part of eye screening details information. Hey, Everyone, I am from takecareofeyes.com and today I will discuss the innovative eye care tips and tricks.
Some Important Parts of Innovative Eye Care:
- Eye Screening Charts for Community Workers
- Measuring Tape
- Eye Care Educational Materials
- Register / Pen
- Referral Slip
01. Eye Screening Charts for Community Workers
These charts are used for the purpose of testing visual acuity and detecting potential problems that the patient may not be aware of.
02. Measuring Tape
During visual acuity testing, individuals attempting to read the “E-Chart”, “Pictorial Chart” should be standing 20 feet away from the chart in a well-lit area.
This item is used to identify the point 20 feet away from the chart and thus where the individual should be standing. Measuring tape is part of Innovative Eye Care screening.
03. Eye Care Educational Materials
This material contains information regarding the identification of common eye problems (written in the local language) with visual aids to complement the written descriptions. Instructions on proper hygiene and preventative measures are also included.
Special educational material such as “did you know”; that covers different eye diseases with a picture, the affected part of the eye, cause, signs and the treatment.
04. Register / Pen
The register allows the tester to record cases where an individual that is suffering from a problem that requires further treatment.
05. Referral Slip
In the event that an individual is suffering from an ailment that requires further treatment, a referral slip is to be filled out by the tester detailing the problem and turned over to the patient or their guardian. Referral slip is also an important part of Innovative Eye Care screening.
In the event that a patient is suffering from cataracts, if they are able to travel to Kalinga Eye Hospital and present a valid Referral Slip they will be eligible for cataract surgery free of charge.
Screening Process Guidelines
This item provides a quick reference for the tester regarding best practices and standard operating procedures for vision screening activities.
Below are the methods the animators will be used for identifying the eye diseases during the eye screening program at the community level.
- Torch Light Examination
- Eye Movement Test
- Vision test using the Chart
Before conducting the examination, an animator will have a discussion with the patient, his parents, attendants, concern school teacher / Anganwadi worker, asking them if s/he is suffering from any types of eye disease to his /her knowledge and though this discussion the animator may able to identify the following eye diseases:
- Poor night vision,
- Refractive Error
- Pain in eye,
- Black patches,
- Double Vision
- Floaters- flashes
- Continuous itching.
02. Torch Light Examination:
Some Eye diseases can be identified by conducting the torchlight examination and with this examination, the following eye ailments may be identified.
- Corneal Scar
- Corneal Ulcer
- Eye Injury
03. Eye Movement Test:
Eye movement test is an examination of the function of the eye muscles. Usually, we observe the movement of the eyes in eight specific directions. Here the patient is asked to sit or stand with their head erect and a forward gaze. Eye movement test is another important part of Innovative Eye Care.
The animator will hold a torchlight or other object 12 inches in front to the patient’s face. He or she will then move the object in eight different directions and the patient will be asked to follow it with their eyes, without moving their head.
04. Vision test using the Chart:
Different type of Vision Screening charts are provided with the KIT and each chart should be kept in a well-lighted area and at a 20 feet distance from the patient. Then the patients are asked to close one of their eyes with their palm and try to read/recognize the letters/ pictures in the chart and s/he will continue the examination for the other eye also.
Screening of 0-2 year Children & the School Drop Out children:
The animators will be trained and provided with a special eye screening kit containing an attractive noisy toy, a pen torch/torchlight, educational materials on Pediatric Eye care, Register and a referral slip.
As the children under this age group can’t read, they will be only examined by torchlight for any congenital ophthalmic problems, conjunctivitis, and examination of the ocular structure, tearing, cataract, strabismus or any other ophthalmic problem which can be identified easily.
Young children, up to two years old (usually this group of children can be found in a home), cannot respond to the requests of the screener, so in order to check their eyesight, the screener uses the natural reactions of small children.
The screener will go to each house with a small child and ask the mother or grandmother to bring the child to the door and hold him or her.
The first step is to ask the caretaker if they have noticed any eye problems with the child, and then to use at torchlight to examine the child’s eyes. The torch canal so is shined on baby’s eyes while he or she is sleeping, to see if he or she reacts by squinting.
The screener then uses a noisy toy to test the child’s ocular movement. Since the screener cannot ask a baby to follow a point with just their eyes, a noisy toy is used to all the baby’s attention in different directions to track the movement of his or her eyes.
The mother then can cover each of the baby’s eyes individually, and see if there is a stronger reaction when one eye is covered compared to the other eye.
If the baby fusses when one eye is covered, but not the other eye, then that is a sign that one eye has problems. Another test can be done for children over a year old using medium sized sugar grains. The child is fed a sugar grain – and discovers that they are tasty.
Several grains are then laid o t across a piece of paper, and the screener sees if the child can find these grain s with one eye or the other covered. Similarly, the school dropout children can be screened at home or by taking the assistance of the ASHA worker s, working under the NRHM Program.
Also, the animator will conduct the cover test, through which they will close one eye of the child with thumb/palm and will try to draw the attention of the child towards an object.
If the Child cries (resist)/does not allow closing, then poor vision is suspected, and the child is referred to an ophthalmologist. This test will be conducted on both the eyes of the child.
For screening of the school drop-out children’s the animators are provide d with a specially designed chart holding only one English alphabet “E” of the size of 6/9 (instead of providing the workers a total Snelle n’s Chart, Kalinga Eye Hospital has designed a new chart that contains s only 4 Es of size 6/9.
There are two reasons for designing this chart: a) going through Snellen’s Chart during community eye screening will take a lot of time, so only 6/9 letter is used.
If the child cannot read this letter, s/he has some ophthalmic problems and is referred to an optometrist or ophthalmologist for further investigation; b) considering the poor literacy level of the community, the letter “E” facing different directions is selected, so during screening children only have to show the direction of the three pillars of the letter “E”. Children identified.
Screening of 3 -5years:
Screening children aged three to five follows similar steps but differs in that the screener can request actions of the child. The screening takes place at Anganwadi, the local playschool r preschool, or at a central location that mothers are asked to bring their children to.
Mothers and Anganwadi workers are asked if they have noticed eye problems in their children, and since the children are older, it is possible for the screener to ask them if they have eye problems.
The torchlight can be used not only to examine their eyes but also for the ocular movement test.
For this age group, an eye chart is used to measure visual acuity. The screener is provided with a 6/9 broken ring cum pictorial chart, which has pictures on it for those who cannot understand the broken rings.
The kit includes a tape measure which is used to measure twenty feet from the chart, and then draw a box for a person to stand in while their vision is measured.
The child covers one eye with their palm (not their fingers – using their fingers could put pressure on the eyeball, which would cause their vision to be blurry, and they could also peek through their fingers) and tries to figure out the way out of the ring or what object the pictures represent.
Screening of 6-16years:
For children aged six to sixteen, eye exams are carried out in school, during the daily game period. This means that the exams are not taking away time from regular classes, and they are also treated like a game, to make them fun and make children more likely to show up.
The procedure is rather similar – the screener will ask the teacher, then the children, if they notice any problems with their eyes, and use a torchlight to examine their eyes and conduct an ocular movement test. A different chart is used to assess children and adults, though.
This chart is known as an E chart, and it features figures that look like the letter E rotated in different directions.
The child stands twenty feet away from the chart, covers one eye at a time with their palm, and points in the direction that the sticks on the E are facing.
This chart is a 6/9 chart, and the smaller size of figures allows the screener to quickly tell if the child is having vision problems. Using one line of Snell’s chart rather than the whole chart makes it faster and easier to screen people.
The screener need not go through every line of every chart with every patient; rather, he Or she can assume that if the person cannot read the line provided, that they are having trouble seeing.
If the screener thinks that the child has memorized the order of the figures, then the screener can point to random figures, to keep the child guessing.
School eye screening camp is an effective way to provide eye care to children in remote places. They are also made aware of some of the sign & symptoms of eye problems, like wandering eye or the eye, tilt head, constant rubbing of an eye, tumbling, droopy eyelid, etc.
Additionally, the animators are also oriented on the concept of prevention of eye injuries, first aid emergency care, prevention of common eye problems, classroom illumination, and role of nutrition in the maintenance of lifelong good vision.
The team at Kalinga Eye Hospital found that that many school children needing glasses don’t get them because of their refractive errors are not detected, which hampers children’s physical, cognitive and psychological development and future employability and earning potential.
Moreover, if refractive error is detected late, the child can suffer from amblyopia- a condition where vision remains low even wearing the glasses. The condition can only be treated only until 7-8 years of age, hence the importance of early detection.
While selecting school teachers, importance will be given to female teachers with a science education background, any teacher that wears glasses so that s/he could understand the problem of low vision.
Here are some other signs that can help to detect children with ophthalmic ailments:
- If the child holds books or small objects close to the eyes.
- Is unduly sensitive to light.
- Is unable to see the blackboard or has double vision.
- Is unable to participate in games requiring distant vision.
- Is irritable and has difficulty while reading.
- Rubs his eyes frequently, blink often.
- Expressively tilts or thrusts or thrusts head forward when looking at near objects or narrows eyelids while looking at a distance.
- Has burning sensation in eyes.
- Poor academic performances.
- Squinting eyes
Screening of the Adults:
For adults, aged sixteen to forty-five, the same procedures are used. One technique that can also be used is the pen touching test.
A person holds a pen in each hand, with the tips of the pens facing inward. The person then moves the tips of the pens together and tries to touch them, first with both eyes open and then with one closed.
This exercise also shows people the importance of both eyes for judging distance. Screening of the adults is part of Innovative Eye Care.
The pen test is an interesting way to show people that vision in both eyes is important, but this test is not used with every patient. For patients aged forty-five and older, a different chart is used. This E chart has figures that are 6/36, meaning that they are larger.
Under this category, the animators are provided with specially designed E- Chart, measuring tape to measure the 20 feet distance. This specially designed chart holding only one English alphabet “E” of the size of 6/36, will help to identify the people affected with poor vision due to any ophthalmic diseases.
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