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3.4: Referrals and frequency of screening

Referral pathways

Referrals to ophthalmologists

All children referred should be given an information sheet to take home to their parents. Referral slips given to the child for their parents can be used together with a register at the hospital to track whether the child attended or not. Electronic mobile phone based systems can also be used. Teachers can contribute to ensure follow ups and educate the parents on the importance of uptake on treatment.

Follow-ups on referrals should be covered in the M&E plan of the programme. It is a great opportunity for members of the team to gather information on the uptake on the child’s treatment  and  reasons why it has not been followed if it is the case (eg. cost, lack of time, misbeliefs etc.).

Referrals to low vision clinics

After a clinical diagnosis has been made and treatment given, children with severe vision impairment (VA <6/60; 1.0) or blindness (VA <3/60; 1.3) (WHO classification)  should be assessed in a low vision clinic or rehabilitation services and special education.

Frequency of screenings

School-based screenings should include children starting at the age of 5 or 6 years old. As myopia usually starts during school age, and in some children, progresses over time, schools should be visited every 1-2 years.

The frequency of visits may need to be adjusted for the local context, for example in contexts with high annual incidence of RE amongst older children.

Year 1 of implementation Screen all children as recommended in SOP
Year 2 of implementation Screen new intake AND re-examine all children given spectacles the previous year
Year 3 of implementation As for year 2