Use of the World Health Organization primary eye care protocol to investigate the ocular health status of school children in Rwanda

Assessing the ocular health of primary and secondary schoolchildren in Rwanda and exploring the use of the World Health Organization (WHO) primary eye care screening protocol was the main objective of this cross-sectional population-based study. A total of 24,892 children from 19 schools underwent ocular health screening using the WHO protocol, which involved measuring visual acuity and identifying abnormal ocular features through a flashlight and history checklist. Results revealed that 7.5% of the children failed the primary screening, with 2.6% being false positives and 4.8% true positives. All children with abnormal screening were referred to an on-site ophthalmic clinic or a hospital for specialist care. The most common ocular diagnoses were allergic conjunctivitis (3.11%) and strabismus (0.26%), while refractive error was infrequent (0.18%). The study concluded that the WHO primary eye care curriculum offers an effective approach for school-based vision screening, utilizing standardized checklists and low-cost resources. In Rwanda, the majority of ocular problems could be identified through visual inspection, highlighting the efficiency of the screening protocol and its potential for widespread use in identifying and managing ocular health issues among schoolchildren.

Publication date

January 13, 2023


Journal of American Association for Pediatric Ophthalmology (JAAPOS)


Wanjiku Ciku Mathenge; Nicholas R. Bello; Olivia M. Hess; Jean-Marie Dangou; John Nkurikiye; Alex V. Levin
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