Abstract
Purpose:
Mongolia has no official system for vision screening. This project introduced ision screeningto school health division in Mongolia through corporation with the Mongolian Opthalmologists's Society, The Japanese Association of Certified Orthoptists, and The Association of Medical Doctors of Asia.
Methods:
345 first graders ( boys 176 and girls 169) attending a large elementary school in Ulaanbaatar city learned how to perform the visual acuity test using a Landold C chart at distance, and how to respond to the Lang stereo test, Cover test and refraction (with auto-refractometer) were done on each subject. Ophthalmologists and optometrists in Mongolia and Japanese orthoptists performed all tests. School doctors and ophthalmologists in Mongolia observed this screening on site to learn the real situation. Students were referred to local opthalmologists for ocular disease or if acuity was 0/7 or less.
Results:
87.5% of subjects had no detectable vision problems. Acuity was <0.7 for 46 right eyes (RE) and 45 left eyes (LE). Refraction revealed mean sperical error 0.14D +/- 1.06 (RE), 0.24D+/- 0.92 (LE) and cylindrical error 0.59 D +/-0.60 (RE), 0.60 D +/- 0.61 (LE). Cover test revealed 49 exophoria and 4 esophoria; 1 exotropia and 1 esotropia. There were 2 hyperphoria and 1 nystagmus. 8 subjects failed the stereo test. Based on these findings, 48 students were referred; 43 went to see the ophthalmologists and 37 were prescribed glasses. On examination, 20 subjects were found to be amblyopic (3 anisometropic and 17 ametropic).
Conclusions:
A collabration between Mongolian and Japanese representatives facilitated a new school vision screening program for first grade students. The methods were based on Japanese procedures and standards, which are known to be effective for public health in that country. 10.7 % of students needed correction (low relative to Japan) and 5.8 % were amblyopic (high compared to Japan). We conclude that a vision screening program can be instituted in Mongolia. With early detection of vision problems, academic difficulties can be avoided. The hope is that Mongolian officials will be able to build on these results to continue development of a school vision screening program at the local and ultimately the national level.