Table 1. Studies identified in the systematic review of interventions to improve eye-care services for schoolchildren in low- and middle-income countries.
| Study | Country | Study design | Study sample | Purpose | Quality appraisala |
|---|---|---|---|---|---|
| Castanon Holgui et al., 200634 | Mexico | Prospective observational | 493 primary and secondary schoolchildren aged 5–18 years | Assess spectacle compliance | Low |
| Carvalho et al., 200720 | Brazil | Cross-sectional (prospective) | 1517 elementary school teachers or principals | Assess teacher perceptions of school visual health campaigns | Low |
| Esteso et al., 200726 | Mexico | Prospective observational | 96 primary and secondary schoolchildren (mean age 12 years) | Assess the impact of spectacles on self-reported vision health | Medium |
| Congdon et al., 200835 | South Africa | Prospective observational | 8520 primary and secondary schoolchildren aged 6–19 years | Evaluate refractive error cut-offs for spectacle provision to more effectively identify children with improved vision and increase compliance | Low |
| Lewallen et al., 200858 | United Republic of Tanzania | Mixed methods | 20 schools (10 intervention, 10 control), 1396 schoolchildren (grades 3 and 4) | Evaluate trachoma education outcomes, including knowledge and hygiene practices | High |
| Li et al., 200845 | China | Prospective cohort | 1892 secondary schoolchildren aged 13–16 years | Assess the determinants of spectacle compliance | Medium |
| Odedra et al., 200848 | United Republic of Tanzania | Mixed methods | 108 secondary school students (average age 15 years); 58 intervention group, 50 control group | Assess reasons for poor compliance following in-school provision of spectacles | Medium |
| Wedner et al., 200838 | United Republic of Tanzania | Randomized controlled trial | 125 secondary schoolchildren aged 11–19 years | Assess compliance of free spectacles | High |
| Khandekar et al., 200951 | Islamic Republic of Iran | Mixed methods | 15 parents and 15 teachers | Evaluate school vision screening in kindergarten, including cost and validity of teacher use | Medium |
| Tabansi et al., 200955 | Nigeria | Cross-sectional (prospective) | 130 teachers, 1300 primary schoolchildren aged 6–11 years | Assess accuracy of teacher screenings, compared with research team/doctors | High |
| Zeng et al., 200940 | China | Randomized controlled trial | 743 secondary schoolchildren aged 12–15 years | Evaluate children’s vision and satisfaction with ready-made spectacles | Medium |
| Keay et al., 201044 | China | Prospective observational | 428 secondary schoolchildren aged 12–15 years | Determine what influences ready-made and custom-made spectacle compliance | High |
| Adhikari & Shrestha, 201149 | Nepal | Cross-sectional (prospective) | 20 certified medical assistants | Assess reliability of certified medical assistants in school-based vision screening, compared with paediatric ophthalmologists | Medium |
| Congdon et al., 201165 | China | Randomized controlled trial | 11 423 primary and secondary schoolchildren aged 12–17 years | Effectiveness of an educational intervention to promote spectacle purchase | Low |
| Noma et al., 201132 | Brazil | Cross-sectional (prospective) | 767 parents | Determine reasons for non-adherence to ophthalmic examinations following school screening | Low |
| Santos et al., 201137 | Brazil | Cross-sectional (prospective) | 62 primary schoolchildren aged 6–11 years with refractive error | Assess compliance of children to their first pair of glasses | Low |
| Noma et al., 201233 | Brazil | Cross-sectional (prospective) | 14 651 primary schoolchildren aged 7–10 years | Determine reasons for non-adherence to ophthalmic examinations following school screening | High |
| Pereira et al., 201221 | Timor-Leste | Cross-sectional (prospective) | 21 school health nurses, 1819 children screened | Evaluate efficacy of eye health outreach services | Medium |
| Rajaraman et al., 201223 | India | Mixed methods | 52 children aged 9–17 years, 35 school staff, 13 school health counsellors, 4 parents and 3 clinicians | Evaluate the effectiveness of delivery of school health promotion by lay school health counsellors | High |
| Rustagi et al., 201236 | India | Mixed methods | 51 secondary schoolchildren aged 11–18 years, sampled for refraction, out of 1075 screened | Assess the magnitude of vision impairment among children and their spectacle compliance | Medium |
| Balasubramaniam et al., 201364 | India | Qualitative | 35 parents with school-aged children and 16 eye-care specialists | Effectiveness of school vision screening | Medium |
| Gogate et al., 201343 | India | Cross-sectional (prospective) | 1018 secondary schoolchildren aged 8–16 years | Assess spectacle compliance among rural children | High |
| Rewri et al., 201361 | India | Cross-sectional (prospective) | 7411 secondary schoolchildren aged 11–19 years | Evaluate students’ ability to self-examine their vision and seek intervention such as spectacles | High |
| Thummalapalli et al., 201360 | India | Prospective observational | 104 primary school teachers | Evaluate effectiveness of eye health promotion and screening intervention among teachers | Low |
| Bai et al., 201462 | China | Cross-sectional (retrospective) | 19 977 primary school students (in grades 4 and 5) | Effectiveness of school vision screening | Medium |
| Latorre-Arteaga et al., 201452 | Peru | Cross-sectional (prospective) | 21 teachers | Evaluate the effectiveness of teacher vision screening and estimate childhood refractive error prevalence | Medium |
| Ma et al., 201446 | China | Randomized controlled trial | 3177 primary schoolchildren aged 8–13 years in 251 schools | Assess the effect of free spectacle provision on academic performance | Medium |
| Puri et al., 201422 | India | Cross-sectional (prospective) | 5404 children aged 8–15 years screened and 71 teachers surveyed | Evaluate school vision programme | Medium |
| Teerawattananon et al., 201456 | Thailand | Mixed methods | 5885 students; 1335 pre-primary children aged 4–6 years, 4550 primary children aged 7–12 years | Assess accuracy and feasibility of teacher screening | Medium |
| Zhou et al., 201425 | China | Mixed methods | 136 urban primary schoolchildren aged 9–11 years, 290 rural secondary schoolchildren aged 11–17 years, 16 parents | Assess the take-up of adjustable-lens spectacles among children and parents | High |
| Anuradha & Ramani, 201563 | India | Cross-sectional (prospective) | 123 optometrists or optometry students | Effectiveness of optometry students in conducting school-based single-day vision screening | High |
| Fontenele et al., 201527 | Brazil | Cross-sectional (prospective) | 94 school health nurses aged 20–29 years | Assess the involvement of nurses in children’s eye health | Medium |
| Hobday et al., 201528 | Timor-Leste | Mixed methods | 384 primary schoolchildren aged 10–17 years; teachers and parents (number undisclosed) | Evaluate an in-school health promotional intervention | Medium |
| Juggernath & Knight, 201529 | South Africa | Randomized controlled trial | 37 teachers or principals; 19 in intervention group (aged 23–67 years), 18 in control group (aged 21–59 years) | Assess teacher visual acuity screening following training | Medium |
| Ma et al., 201531 | China | Randomized controlled trial | 2840 primary schoolchildren aged 8–13 years in 249 schools | Assess the safety of spectacles in rural context where a fear that spectacles harm the eyes is an important barrier | High |
| Priya et al., 201553 | India | Case–control | 917 teachers | Assess cost and effectiveness of screening programme involving all teachers, compared with using a limited number of teachers | High |
| Saxena et al., 201554 | India | Cross-sectional (prospective) | 40 teachers, 9838 primary schoolchildren aged 6–15 years | Assess accuracy of teacher screenings, compared with primary eye-care workers | High |
| Wang et al., 201524 | China | Cross-sectional (prospective) | 4376 primary schoolchildren aged ~9–12 years; 4225 migrant children and 151 local children | Measure prevalence of spectacle need and ownership among migrant children | Low |
| Yi et al., 201539 | China | Randomized controlled trial | 693 primary schoolchildren aged 10–12 years | Assess the effect of the provision of free spectacles, combined with teacher incentives, on compliance | High |
| Glewwe et al., 201642 | China | Mixed quantitative | 28 798 primary schoolchildren aged 10–12 years | Determine the impact of free spectacle provision on children’s academic performance | High |
| Kaur et al., 201650 | India | Cross-sectional (prospective) | 253 teachers | Assess the effectiveness of teacher screening in identifying eye problems in children | Medium |
| Latorre-Arteaga et al., 201630 | Peru | Cross-sectional (prospective) | 355 teachers | Assess teacher screening programme implementation following pilot phase | High |
| Chan et al., 201757 | United Republic of Tanzania | Cross-sectional (prospective) | 120 schoolchildren aged 11–12 years | Effectiveness of child-to-child health promotion strategy | High |
| de Melo et al., 201719 | Brazil | Cross-sectional (prospective) | 74 primary and secondary schoolchildren aged 13–18 years | Effectiveness of an educational intervention on the topic of disability | Low |
| Morjaria et al., 201747 | India | Randomized controlled trial | 460 secondary school aged 11–15 years; 232 ready-made spectacles, 228 custom-made spectacles | Compare compliance between ready- and custom-made spectacles | Medium |
| Paudel et al., 201759 | Viet Nam | Prospective cohort | 300 children aged 12–15 years | Assess the effect of eye health promotion on eye health literacy in schools | High |
| Ebeigbe, 201866 | Nigeria | Qualitative | 35 parents of schoolchildren aged 5–12 years | Assess the factors that influence the seeking of eye-care | Medium |
| Narayanan & Ramani, 201841 | India | Non-randomized controlled trial | 8442 secondary schoolchildren aged 13–17 years screened; 238 required spectacles, of which 124 formed the intervention group and 114 the control group | Assess spectacle and referral compliance following school screening programme | Low |
a We appraised the quality of study methods by using the Mixed Methods Appraisal Tool (v-2011). Studies were classified as high quality if > 90% of criteria were adequate, medium quality if > 60 to 90% of criteria were adequate, low quality if > 30 to 60% of criteria were adequate and very low quality if ≤ 30% criteria were adequate. No studies of very low quality were eligible for inclusion, so no studies were excluded based on this quality assessment.