Page 181 - DISINVESTMENT AND IMPLEMENTATION OF VISION SCREENING TESTS BASED ON THEIR EFFECTIVENESS

months of age should have been re-tested within 3 months. In practise re-testing was often postponed to the regular screen nine months later, at 45 months of age. This indicated non-adherence to the CHC guideline. Measurements of VA at the age of 36 months by CHC physicians cannot be recommended as a screening test in the general population. When these VA measurements would be performed by orthoptists, the failure rate would be lower, but this would however, be prohibitively expensive.
Due to the new insights provided by the model simulation, the OVAS disinvestment study and the large diversity in screening programmes, we were able to start the European Horizon-2020 study, EUSCREEN, to compare the cost-effectiveness of vison screening programmes in Europe. In this study the cost-effectiveness model is developed further and, guided and informed by the model, an implementation study of vision screening was started in Cluj Romania, where no population-wide vision screening exists. Out of 12,795 eligible four- and five-year-old children, 7,876 were screened. Screening in the cities was performed by resident nurses at the Kindergartens. Screening in rural areas was performed by GP nurses. The most conspicuous finding in the implementation study was that vision screening in rural areas was much more difficult than in urban areas. Cities in Romania have large kindergartens and all kindergartens have nurses, who were able to successfully measure VA at age 4 and 5 years. For nationwide implementation of vision screening in Romania, finding a feasible way to screen in rural areas is imperative, because 46% of the country’s population lives in rural areas.
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General discussion
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