OCULAR PATHOLOGIES IN CHILDREN: VAL-IDATION STUDY OF A SCREENING METHOD DURING SCHOOL YEARS. MARCH - DECEM-BER 2010, MONTEVIDEO, URUGUAY.

Abstract

The objective of the «National Program of Ocular Health» is to tackle the avoidable and treatable causes of blindness. Within this framework, the Department of Community and Family Medicine has developed  activities related to Health Promotion and Prevention of ocular illnesses and problems in childhood. This activity was planned and took place in an interdisciplinary way, with the participation of medical degree students, students of opthalmology, and ophthalmologists and with the participation of different sectors suc has Hospital de Ojos, Ministry of Social Development and the Chamber of Opticians. This work includes the assessment of competences acquired by the students when screening visual alterations (inter-observer agreement degree). The objective was to evaluate the validity and safety of medical students applying a screening method of ocular pathology in kindergarten and school students at three institutions of Zonal 12 in Montevideo (March-December 2010). Method: Medical students were trai ned with a blended-learning approach (attending classes and on line classes) and offi ce practices. Screening days were double blind and kids were evaluated by a student and an ophthalmologist. Visual acuity with Snellen Chart and ocular alignment using the Hirsch berg test were systematically explored. Results: One hundred ninety-six children between 5 and 8 years old were studied; 13.7 % required referral due to defi cit in visual acuity and 2.5% because of strabism us. The agreement between students and technicians regarding referral due to visual acuity defi cit was 94% and strabismus 96%. Kappa value for visual acuity was 0.77 and for strabismus 0.53. Students ́sensitivity for visual acuity was 88 .9% and 100% for strabismus. Specifi city was 94.7% for visual acuity and 95.8% for strabismu s. Positive predictive value was 72.7% for visual acuity and 38.4% for strabismus and the negative predictive value was 98.1% for visual acuity and 100% for strabismus.  conclusions: The percentage of derivatives is similar to that of previous works. From the results of the study, it would be appropriate to include the screening of visual alterations by trained medical students at educational institutions, since it optimizes interventions at primary health care.