Abstract

EFFICIENT AND COST EFFECTIVE VISION SCREENING FOR SCHOOL-AGED CHILDREN IN BULGARIA

A. Oscar*, V. Haykin, A. Aroyo, A. Levi, V. Chernodrinska, Ch. Elenkov

ABSTRACT

Background: Vision screening detects visual disorders causing reduced visual acuity, like amblyopia. Amblyopia has a public health importance and prevalence of 2 – 4%. Purpose: evaluating the efficiency and cost-effectiveness of the vision screening performed by us in Bulgaria. Methods: Visual acuity testing, stereopsis, orthoptics, ocular motility, non-cycloplegic refraction, direct ophthalmoscopy, external ocular inspection and as needed cycloplegic refraction and indirect ophthalmoscopy were performed. Patients: 4525 children (2236 females, 2289 males), divided into groups by province of residence: Vidin 1905 children; Montana 1120 children; Vratsa 623 children; Kyustendil 591 children; Plovdiv 286 children. Results: A total of 4066 children (89.8%) had never been examined by an ophthalmologist. Amblyopia had 168 children (3.7%). Refractive errors were found in 751 children (16.6%). Strabismus was observed in 50 children (1.1%). Mean cost of examination/child: EUR 6.14/incl. eyeglasses. Treating amblyopic child costs EUR 265.88/6 months. Total cost of the Screening: EUR 27783.5. Treating only the amblyopic children costs: EUR 44667.84. Conclusions: The lack of vision screening in Bulgaria is the main cause for the late diagnosis of treatable eye diseases. Screening programs are effective in detecting refractive errors and preventing amblyopia. The “Do good” project provides full ophthalmological examination at minimum cost. The effective and cost-beneficial design could be used in establishing a national child vision screening in Bulgaria.

Keywords: Screening; Cost effectiveness; Eye disorders.