Assessing the Ability of Nonophthalmic Nurses to Screen for Vision and Detect Common Eye Conditions in Preschool Children at a Pediatric Outpatient Clinic of a Tertiary Hospital in Nigeria

Background: Good eyesight is an important requirement for a child’s physical, social, academic, and emotional development. Vision screening can aid in the early detection of visual problems as well as life-threatening conditions like retinoblastoma. This study assessed the ability of nonophthalmic nurses to accurately conduct vision screening and detect common eye conditions in preschool children at a tertiary hospital in Nigeria. Methods: This was a hospital-based cross-sectional study conducted over 12 weeks. Twenty-one nonophthalmic nurses were trained to assess visual acuity (VA), perform pen torch examination and Bruckner’s test in preschool children. Systematic random sampling was used to select 415 preschool children who were first examined by the trained nurses and then reexamined by the principal investigator (PI) (a senior registrar in ophthalmology). Accuracy was determined by sensitivity and specificity, positive and negative predictive values, and kappa scores to determine the level of agreement. Statistical significance was set at a P value < 0.05. Results: A total of 411 (63.3% males and 36.7% females) preschool children, with a mean age of 4.5 years, were examined. The trained nurses had a sensitivity of 82.4% and a specificity of 97.9% for assessing VA (kappa score of 0.790). They also had good agreement for the detection of common eye conditions like conjunctivitis and corneal opacity. When compared with the PI, there was no statistically significant difference in their detection rate for all observed variables, except for strabismus. Conclusion: The study showed that trained nonophthalmic nurses can adequately assess VA and detect common eye conditions in preschool children.