A Comprehensive Systematic Review of The Role of Screening Programs in Preventing Blindness in Primary Setting
Keywords:
Blindness prevention, screening programs, primary care, diabetic retinopathy, telemedicine, artificial intelligence, visual impairment, systematic reviewAbstract
Introduction: Blindness and visual impairment represent significant global public health challenges, with many causes being preventable or treatable if detected early. Screening programs in primary care settings are widely advocated as a key strategy to reduce the burden of avoidable vision loss. However, the effectiveness of these programs varies substantially across different eye conditions, populations, and healthcare contexts.
Methods: This comprehensive systematic review synthesises evidence from 80 studies examining the role of screening programs in preventing blindness within primary care settings. The review employed a structured screening process to include studies conducted in primary care, involving systematic screening interventions, with outcomes related to blindness prevention. Data extraction covered screening program details, primary care context, target population, visual outcomes, effectiveness results, implementation factors, and economic considerations.
Results: The evidence reveals a paradox: while screening effectively identifies individuals with visual impairment, it does not consistently lead to improved visual outcomes at the population level. General visual acuity screening in older adults showed no significant benefit in improving vision or clinical outcomes (Clarke et al., 2018; Smeeth et al., 2003; Chou et al., 2016). In contrast, screening for diabetic retinopathy (DR) demonstrated efficacy, with telemedicine and AI-supported approaches significantly increasing screening uptake, detection rates, and referral adherence (Mansberger et al., 2015; Mathenge et al., 2022; Harding et al., 2023). Evidence for glaucoma population screening remains insufficient (Mangione et al., 2022), while preschool vision screening for amblyopia shows modest benefits (Schmucker et al., 2009). Newborn red reflex testing may improve early detection of congenital cataracts (Malik et al., 2022). Economic analyses indicate that telemedicine and AI-supported screening, particularly for DR, are cost-effective, especially in resource-limited settings (Avidor et al., 2020; Teo & Ting, 2023).
Discussion: The disparity in outcomes underscores the critical influence of context, including baseline healthcare access, the natural history of the disease, availability of effective treatment, and the strength of referral pathways. Successful programs integrate technology with systemic support, such as patient navigation and removal of financial barriers.
Conclusion: Screening is not a uniformly effective intervention for all eye conditions in all settings. Its value is highest for conditions like diabetic retinopathy within defined high-risk populations and in contexts with limited baseline eye care access. Future programs should be condition-specific, contextually tailored, and designed as integrated care pathways rather than isolated detection activities.
References
A. N. Jensen, Birte Bay Højsted, Victoria Eichel, Mie Klarskov Jensen, T. Sørensen, and Maria Kristiansen. “Community-Based Interventions to Detect Visual Impairment in Community-Dwelling Older Adults Aged ≥ 75 Years: A Systematic Review.” BMC Public Health, 2025.
Aeesha N J Malik, J. Evans, Shuchita Gupta, S. Mariotti, Iris Gordon, Richard C Bowman, and Clare Gilbert. “Universal Newborn Eye Screening: A Systematic Review of the Literature and Review of International Guidelines.” Journal of Global Health, 2022.
Afua O. Asare, Agnes Wong, D. Maurer, Yalinie Kulandaivelu, N. Saunders, and W. Ungar. “Economic Evaluations of Vision Screening to Detect Amblyopia and Refractive Errors in Children: A Systematic Review.” Canadian Journal of Public Health, 2021.
Binita Bhattarai, Saraswati Khadka, Thapa, H. Thapa, Sandip Bashyal, Bhesh Bikram Thapa, Chhetri, Samiksha Singh, and Hemant Mahajan. “Structured Counselling and Regular Telephonic Follow Up Among Diabetic Retinopathy Patients to Improve Timely Referral Flow and Compliance from Peripheral Eye Care Centre to Tertiary Centre in Nepal: A Randomised Controlled Trial (Preprint),” 2021.
C. Mangione, M. Barry, Wanda Nicholson, Michael Cabana, D. Chelmow, Tumaini R. Coker, E. Davis, et al. “Screening for Primary Open-Angle Glaucoma: US Preventive Services Task Force Recommendation Statement.” Journal of the American Medical Association (JAMA), 2022.
C. Mangione, Michael J. Barry, Wanda Nicholson, Michael Cabana, David Chelmow, Tumaini R. Coker, Esa M Davis, et al. “Screening for Impaired Visual Acuity in Older Adults: US Preventive Services Task Force Recommendation Statement.” Journal of the American Medical Association (JAMA), 2022.
C. Schmucker, R. Grosselfinger, R. Riemsma, G. Antes, S. Lange, W. Lagrèze, and J. Kleijnen. “Effectiveness of Screening Preschool Children for Amblyopia: A Systematic Review.” BMC Ophthalmology, 2009.
Charles R Cleland, C. Bascaran, William U Makupa, Bernadetha R Shilio, Frank Sandi, Heiko Philippin, Ana Patricia Marques, et al. “Artificial Intelligence-Supported Diabetic Retinopathy Screening in Tanzania: Rationale and Design of a Randomised Controlled Trial.” BMJ Open, 2024.
D. Avidor, A. Loewenstein, M. Waisbourd, and A. Nutman. “Cost-Effectiveness of Diabetic Retinopathy Screening Programs Using Telemedicine: A Systematic Review.” Cost Effectiveness and Resource Allocation, 2020.
D. Broadbent, Amu Wang, C. Cheyne, James G. Lathe, I. Stratton, J. Vora, M. García-Fiñana, M. James, and S. Harding. “39-LB: Individualised Screening for Diabetic Retinopathy: The ISDR Study—A Randomised Controlled Trial of Safety, Efficacy, and Cost-Effectiveness.” Diabetes, 2019.
D. Broadbent, Amu Wang, C. Cheyne, M. James, James G. Lathe, I. Stratton, J. Roberts, et al. “Safety and Cost-Effectiveness of Individualised Screening for Diabetic Retinopathy: The ISDR Open-Label, Equivalence RCT.” Diabetologia, 2020.
Emily L. Clarke, J. Evans, and L. Smeeth. “Community Screening for Visual Impairment in Older People.” Cochrane Database of Systematic Reviews, 2018.
Emily M. Schehlein, Dayakar Yadalla, D. Hutton, J. Stein, R. Venkatesh, and Joshua R. Ehrlich. “Detection of Posterior Segment Eye Disease in Rural Eye Camps in South India: A Non-Randomized Cluster Trial.” Ophthalmology Retina, 2021.
F. Riordan, A. Murphy, C. Dillon, J. Browne, P. Kearney, Susan M. Smith, and S. McHugh. “Feasibility of a Multifaceted Implementation Intervention to Improve Attendance at Diabetic Retinopathy Screening in Primary Care in Ireland: A Cluster Randomised Pilot Trial.” BMJ Open, 2021.
F. Riordan, E. Racine, Susan M. Smith, A. Murphy, J. Browne, P. Kearney, C. Bradley, M. James, Mark E Murphy, and S. McHugh. “Feasibility of an Implementation Intervention to Increase Attendance at Diabetic Retinopathy Screening: Protocol for a Cluster Randomised Pilot Trial.” Pilot and Feasibility Studies, 2020.
F. Sloot, Aya Sami, H. Karaman, S. Loudon, T. Sjoerdsma, J. Benjamins, H. Raat, and H. Simonsz. “Disinvestment Study of Population-Wide Eye Screening in the Netherlands: Effect of Omission of Preverbal Eye Screening at Age 6-9 Months,” 2014.
G. Judah, I. Vlaev, Laura H. Gunn, D. King, Derek King, Jonathan Valabhji, A. Darzi, and C. Bicknell. “Incentives in Diabetic Eye Assessment by Screening (IDEAS): Study Protocol of a Three-Arm Randomized Controlled Trial Using Financial Incentives to Increase Screening Uptake in London.” BMC Ophthalmology, 2016.
Hillary Rono, A. Bastawrous, D. Macleod, Emmanuel Wanjala, Gian Ditanna, H. Weiss, and M. Burton. “Smartphone-Based Screening for Visual Impairment in Kenyan School Children: A Cluster Randomised Controlled Trial.” Lancet Global Health, 2018.
Hillary Rono, A. Bastawrous, D. Macleod, Emmanuel Wanjala, S. Gichuhi, and M. Burton. “Peek Community Eye Health - mHealth System to Increase Access and Efficiency of Eye Health Services in Trans Nzoia County, Kenya: Study Protocol for a Cluster Randomised Controlled Trial.” Trials, 2019.
Hillary Rono, A. Bastawrous, D. Macleod, Ronald Mamboleo, C. Bunywera, Emmanuel Wanjala, S. Gichuhi, and M. Burton. “Effectiveness of an mHealth System on Access to Eye Health Services in Kenya: A Cluster-Randomised Controlled Trial.” The Lancet Digital Health, 2021.
———. “Increasing Access to Eye Health Services in Kenya Using an mHealth System: A Cluster Randomised Controlled Trial,” 2020.
J. Aubert, P. Massin, Ghislaine Audran, A. Ben Mehidi, Blandine Bernit, S. Bouée, M. Bouhassira, et al. “[Evaluation of a Screening Programme for Diabetic Retinopathy (DODIA Study)].” La Revue Du Praticien, 2007.
J. Burr, G. Mowatt, Rodolfo Hernández, M. A. R. Siddiqui, J. Cook, Tânia Lourenço, Craig R Ramsay, et al. “The Clinical Effectiveness and Cost-Effectiveness of Screening for Open Angle Glaucoma: A Systematic Review and Economic Evaluation.” Health Technology Assessment, 2007.
J. Evans, L. Smeeth, and A. Fletcher. “Vision Screening.” British Journal of Ophthalmology, 2009.
J. Litaker, Naomi Tamez, Chris Palma, Wesley Durkalski, and Richard Taylor. “A Randomized Controlled Trial to Increase Diabetic Retinopathy Screening by a Community-Based Health Insurance Plan in Central Texas – 2017.” Ophthalmic Epidemiology, 2020.
J. Yip, P. Foster, D. Uranchimeg, Balt Javzandulam, Dash Javzansuren, Tsengenbayar Munhzaya, Pak-Sang Lee, et al. “Randomised Controlled Trial of Screening and Prophylactic Treatment to Prevent Primary Angle Closure Glaucoma.” British Journal of Ophthalmology, 2010.
J. Yuan, K. Prioli, L. Hark, I. Abersone, J. Myers, L. Katz, and L. Pizzi. “PSS6 DIRECT COSTS EXPERIENCED BY THOSE IN A PATIENT NAVIGATOR PROGRAM VERSUS USUAL CARE: RESULTS FROM THE PHILADELPHIA TELEMEDICINE GLAUCOMA DETECTION AND FOLLOW-UP EYE CARE STUDY (PTGD),” 2020.
Jianjun Tang, Y. Liang, C. O’Neill, F. Kee, Junhong Jiang, and N. Congdon. “Cost-Effectiveness and Cost-Utility of Population-Based Glaucoma Screening in China: A Decision-Analytic Markov Model.” Lancet Global Health, 2019.
Jinxiao Lian, S. McGhee, R. Gangwani, A. Hedley, C. Lam, M. Yap, W. Lai, D. Chu, and D. Wong. “Screening for Diabetic Retinopathy with or Without a Copayment in a Randomized Controlled Trial: Influence of the Inverse Care Law.” Ophthalmology (Rochester, Minn.), 2013.
Kieran S. O’Brien, R. Byanju, R. P. Kandel, Bimal Poudyal, Mariya Gautam, J. Gonzales, T. Porco, et al. “Village-Integrated Eye Worker Trial (VIEW): Rationale and Design of a Cluster-Randomised Trial to Prevent Corneal Ulcers in Resource-Limited Settings.” BMJ Open, 2018.
Kieran S. O’Brien, Valerie M Stevens, R. Byanju, R. P. Kandel, G. Bhandari, Sadhan Bhandari, J. Melo, T. Porco, T. Lietman, and J. Keenan. “Cluster-Randomised Trial of Community-Based Screening for Eye Disease in Adults in Nepal: The Village-Integrated Eye Worker Trial II (VIEW II) Trial Protocol.” BMJ Open, 2020.
L. Hark, J. Horowitz, P. Gorroochurn, Lisa Park, Qing Wang, Daniel F. Diamond, N. Harizman, et al. “Manhattan Vision Screening and Follow-up Study (NYC-SIGHT): Baseline Results and Costs of a Cluster-Randomized Trial.” American Journal of Ophthalmology-Glaucoma, 2023.
L. Hark, Y. Kresch, C. G. De Moraes, J. Horowitz, Lisa Park, J. Auran, P. Gorroochurn, et al. “Manhattan Vision Screening and Follow-up Study in Vulnerable Populations (NYC-SIGHT): Design and Methodology.” Journal of Glaucoma, 2021.
L. Robinson, Tania Padilla Conde, and Ana Bastos de Carvalho. “Effectiveness of Telemedicine Diabetic Retinopathy Screening in the USA (Web of Science).” searchRxiv, 2023.
L. Smeeth, A. Fletcher, Smita Hanciles, J. Evans, and R. Wormald. “Screening Older People for Impaired Vision in Primary Care: Cluster Randomised Trial.” British Medical Journal, 2003.
Larisa Wewetzer, Linda A. Held, and J. Steinhäuser. “Diagnostic Performance of Deep-Learning-Based Screening Methods for Diabetic Retinopathy in Primary Care—A Meta-Analysis.” PLoS ONE, 2021.
Liarn Srneeth. “Screening Older People for Impaired Vision,” 2008.
Lindsay A. Rhodes, S. Register, I. Asif, G. McGwin, J. Saaddine, Van Thi Ha Nghiem, C. Owsley, and C. Girkin. “Alabama Screening and Intervention for Glaucoma and Eye Health Through Telemedicine (AL-SIGHT): Study Design and Methodology.” Journal of Glaucoma, 2021.
M. Katibeh, Hamideh Sabbaghi, Masomeh Kalantarion, H. Nikkhah, B. Mousavi, Ramin Beiranvand, H. Ahmadieh, and P. Kallestrup. “Eye Care Utilization in A Community-Oriented Mobile Screening Programme for Improving Eye Health in Iran: A Cluster Randomized Trial.” Ophthalmic Epidemiology, 2020.
M. Zwarenstein, Susan K Shiller, R. Croxford, Jeremy M Grimshaw, Jeremy M Grimshaw, Diane Kelsall, J. Paterson, et al. “Printed Educational Messages Aimed at Family Practitioners Fail to Increase Retinal Screening Among Their Patients with Diabetes: A Pragmatic Cluster Randomized Controlled Trial [ISRCTN72772651].” Implementation Science, 2014.
Mayu Nishimura, Agnes Wong, and Daphne Maurer. “Continued Care and Provision of Glasses Are Necessary to Improve Visual and Academic Outcomes in Children: Experience from a Cluster-Randomized Controlled Trial of School-Based Vision Screening.” Canadian Journal of Public Health, 2024.
N. Mwangi. “Diabetic Retinopathy in Kenya: Assessment of Services and Interventions to Improve Access,” 2020.
N. Mwangi, C. Bascaran, Mark Ng’ang’a, Jacqueline Ramke, Mathew K. Kipturgo, S. Gichuhi, M. Kim, et al. “Feasibility of a Cluster Randomized Controlled Trial on the Effectiveness of Peer–Led Health Education Interventions to Increase Uptake of Retinal Examination for Diabetic Retinopathy in Kirinyaga, Kenya: A Pilot Trial.” Pilot and Feasibility Studies, 2020.
N. Mwangi, Mark Ng’ang’a, Esbon Gakuo, S. Gichuhi, D. Macleod, Consuela Moorman, L. Muthami, et al. “Effectiveness of Peer Support to Increase Uptake of Retinal Examination for Diabetic Retinopathy: Study Protocol for the DURE Pragmatic Cluster Randomized Clinical Trial in Kirinyaga, Kenya.” BMC Public Health, 2018.
Noha Sharafeldin, A. Kawaguchi, Aishwarya Sundaram, S. Campbell, C. Rudnisky, E. Weis, Matthew T. S. Tennant, and K. Damji. “Review of Economic Evaluations of Teleophthalmology as a Screening Strategy for Chronic Eye Disease in Adults.” British Journal of Ophthalmology, 2018.
P. Massin, Jean-Pierre Aubert, E. Eschwège, A. Erginay, J. Bourovitch, A. Benmehidi, M. Nougarède, et al. “Evaluation of a Screening Program for Diabetic Retinopathy in a Primary Care Setting Dodia (Dépistage Ophtalmologique Du Diabète) Study.” Diabetes & Metabolism, 2005.
P. Newman-Casey, Leslie Niziol, A. Elam, Amanda Bicket, Rithambara Ramachandran, Leroy Johnson, Martha Kershaw, Suzanne Winters, and Maria A. Woodward. “Michigan Screening and Intervention for Glaucoma and Eye Health Through Telemedicine Program: Impact on Vision, Follow-up, and Costs.” Ophthalmology (Rochester, Minn.), 2025.
R. Chou, T. Dana, and C. Bougatsos. “Screening for Visual Impairment in Older Adults: Systematic Review to Update the 1996 U.S. Preventive Services Task Force Recommendation,” 2009.
———. “Screening Older Adults for Impaired Visual Acuity: A Review of the Evidence for the U.S. Preventive Services Task Force.” Annals of Internal Medicine, 2009.
R. Chou, T. Dana, C. Bougatsos, Sara E. Grusing, and I. Blazina. “Screening for Impaired Visual Acuity in Older Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.” Journal of the American Medical Association (JAMA), 2016.
R. Davis, S. Fowler, K. Bellis, J. Pockl, Vytautas Al Pakalnis, and Andrew Woldorf. “Telemedicine Improves Eye Examination Rates in Individuals with Diabetes: A Model for Eye-Care Delivery in Underserved Communities.” Diabetes Care, 2003.
R. Kashim, P. Newton, and O. Ojo. “Diabetic Retinopathy Screening: A Systematic Review on Patients’ Non-Attendance.” International Journal of Environmental Research and Public Health, 2018.
R. Mathur, D. D. de Korne, T. Wong, Donald Tan Tiang Hwee, P. Chiang, E. Wong, B. Chakraborty, and E. Lamoureux. “Shared Care for Patients with Diabetes at Risk of Retinopathy: A Feasibility Trial.” International Journal of Integrated Care, 2019.
S. Agarwal, R. Raman, Rani Kumari, Himanshu Deshmukh, P. Paul, P. Gnanamoorthy, GOVINDASAMY KUMARAMANICKAVEL, and T. Sharma. “Diabetic Retinopathy in Type II Diabetics Detected by Targeted Screening Versus Newly Diagnosed in General Practice.” Annals of the Academy of Medicine, Singapore, 2006.
S. Mansberger, Christina R. Sheppler, G. Barker, S. Gardiner, S. Demirel, K. Wooten, and T. Becker. “Long-Term Comparative Effectiveness of Telemedicine in Providing Diabetic Retinopathy Screening Examinations: A Randomized Clinical Trial.” JAMA Ophthalmology, 2015.
S. Vinker, M. Shpiz, A. Elhayany, and S. Nakar. “[Improvement of Early Detection of Diabetic Retinopathy--a Primary Care Intervention Study].” Harefuah, 2003.
Selina L. Liu, J. Gonder, Ehsan Owrangi, N. Klar, I. Hramiak, Artem Uvarov, and J. Mahon. “Effectiveness of Nonmydriatic Ultra-Widefield Retinal Imaging to Screen for Diabetic Eye Disease: A Randomized Controlled Trial (Clearsight).” Diabetes Care, 2022.
Selina L. Liu, Lewis W Mahon, N. Klar, David C Schulz, J. Gonder, I. Hramiak, and J. Mahon. “A Randomised Trial of Non-Mydriatic Ultra-Wide Field Retinal Imaging Versus Usual Care to Screen for Diabetic Eye Disease: Rationale and Protocol for the Clearsight Trial.” BMJ Open, 2017.
Sera Thomas, Maya Jeyaraman, W. Hodge, C. Hutnik, J. Costella, and Monali S. Malvankar-Mehta. “The Effectiveness of Teleglaucoma Versus In-Patient Examination for Glaucoma Screening: A Systematic Review and Meta-Analysis.” PLoS ONE, 2014.
Shalinder Sabherwal, Anand Chinnakaran, I. Sood, Gaurav Garg, Birendra P Singh, Rajan Shukla, Priya A Reddy, S. Gilbert, K. Bassett, and G. Murthy. “Effect of Door-to-Door Screening and Awareness Generation Activities in the Catchment Areas of Vision Centres on Service Utilization: A Study Protocol (Preprint),” 2021.
Shalinder Sabherwal, Anand Chinnakaran, I. Sood, Gaurav K Garg, Birendra P Singh, Rajan Shukla, Priya A Reddy, S. Gilbert, K. Bassett, and G. Murthy. “Effect of Door-to-Door Screening and Awareness Generation Activities in the Catchment Areas of Vision Centers on Service Use: Protocol for a Randomized Experimental Study.” JMIR Research Protocols, 2021.
Shalinder Sabherwal, Anand Chinnakaran, I. Sood, Gaurav K Gary, Birendra P Singh, Rajan Shukla, Priya A Reddy, S. Gilbert, K. Bassett, and G. Murthy. “Authorship Correction: Effect of Door-to-Door Screening and Awareness Generation Activities in the Catchment Areas of Vision Centers on Service Use: Protocol for a Randomized Experimental Study (Preprint),” 2022.
Sierra K. Ha, Joshua B. Gilbert, Erin Le, Connor Ross, and Alice Lorch. “Impact of Teleretinal Screening Program on Diabetic Retinopathy Screening Compliance Rates in Community Health Centers: A Quasi-Experimental Study.” BMC Health Services Research, 2025.
Sile Yu, Chunhong Yan, Guanghao Qin, E. E. Pazo, Xiangdong He, Peng Qi, Mingze Li, Dongming Han, Wei He, and Xingru He. “Assessing the Impact of AI-Assisted Portable Slit Lamps on Rural Primary Ophthalmic Medical Service.” Current Eye Research, 2025.
Simon Harding, Ayesh Alshukri, D. Appelbe, Deborah Broadbent, Philip Burgess, P. Byrne, C. Cheyne, et al. “Individualised Variable-Interval Risk-Based Screening in Diabetic Retinopathy: The ISDR Research Programme Including RCT.” Programme Grants for Applied Research, 2023.
Stevens Bechange, and Sandeep Buttan. “Effectiveness of Community-Based Eye Care: Process and Considerations.” Lancet Global Health, 2022.
T. Quinn. “Review: Evidence Is Insufficient to Determine the Riskbenefit Ratio for Vision Acuity Screening in Older Adults.” Annals of Internal Medicine, 2016.
T. Wall, W. Marsh-Tootle, Katie Crenshaw, Sharina D Person, Raju V Datla, R. Kristofco, and E. Hartmann. “Design of a Randomized Clinical Trial to Improve Rates of Amblyopia Detection in Preschool Aged Children in Primary Care Settings.” Contemporary Clinical Trials, 2011.
Tania Padilla Conde, Lauren Robinson, Paras Vora, S. L. Ware, A. Stromberg, and Ana Bastos de Carvalho. “Effectiveness of Telemedicine Diabetic Retinopathy Screening in the USA: A Protocol for Systematic Review and Meta-Analysis.” Systematic Reviews, 2023.
Tavé van Zyl, Zhuo Su, Elaine J Zhou, Ryan K. Wong, A. Mohsenin, Spencer Rogers, J. Tsai, and S. Forster. “Providing Prescheduled Appointments as a Strategy for Improving Follow-Up Compliance After Community-Based Glaucoma Screening: Results from an Urban Underserved Population.” Journal of Community Health, 2015.
Thembile Zikhali, C. Kalinda, and Z. Xulu-Kasaba. “Screening of Diabetic Retinopathy Using Teleophthalmology to Complement Human Resources for Eye Health: A Systematic Review and Meta-Analysis.” Clinics and Practice, 2022.
V. Stamenova, M. Nguyen, Nike Onabajo, Rebecca Merritt, O. Sutakovic, Kathryn Mossman, Ivy Wong, et al. “Mailed Letter Versus Phone Call to Increase Diabetic Retinopathy Screening Engagement by Patients in a Team-Based Primary Care Practice: A Prospective, Single-Masked, Randomized Trial.” 2021.
V. Stamenova, Megan Nguyen, Nike Onabajo, Rebecca Merritt, O. Sutakovic, Kathryn Mossman, Ivy Wong, et al. “Mailed Letter Versus Phone Call to Increase Diabetic-Related Retinopathy Screening Engagement by Patients in a Team-Based Primary Care Practice: Prospective, Single-Masked, Randomized Trial.” Journal of Medical Internet Research, 2022.
Vera Rooth, H. V. D. van der Aa, R. P. Wisse, Otto R Maarsingh, Marc Koopmanschap, Jan E E Keunen, Hester Vermeulen, et al. “Health Economic Evaluation of a Nurse-Assisted Online Eye Screening in Home Healthcare to Reduce Avoidable Vision Impairment (iScreen): Study Protocol for a Cluster Randomized Controlled Trial.” Trials, 2024.
Vinothkumar Rajendran, Ramalakshmi Raman, Ashok Vardhan, Sachin Gupta, Abhinaya Bharath, and Thulasiraj D. Ravilla. “Impact of Vision Centres on Achieving Universal Eye Health Coverage: Prevalence, Coverage and Utilisation of Eye Care Services in Southern India.” British Journal of Ophthalmology, 2025.
W. Rezner, A. Rezner, and S. Dutkiewicz. “Effectiveness of Counseling Provided by Primary Care Doctors and Nurses in Increasing Glaucoma Screening Rates.” Journal of Ophthalmology, 2014.
Wanjiku Mathenge, N. Whitestone, John Nkurikiye, Jennifer L. Patnaik, P. Piyasena, P. Uwaliraye, G. Lanouette, et al. “Impact of Artificial Intelligence Assessment of Diabetic Retinopathy on Referral Service Uptake in a Low-Resource Setting.” Ophthalmology Science, 2022.
Yue Ma, N. Congdon, Yaojiang Shi, R. Hogg, Alexis Medina, M. Boswell, S. Rozelle, and Mony Iyer. “Effect of a Local Vision Care Center on Eyeglasses Use and School Performance in Rural China: A Cluster Randomized Clinical Trial.” JAMA Ophthalmology, 2018.
Z. Jessa, B. Evans, David W. Thomson, and G. Rowlands. “Vision Screening of Older People.” Ophthalmic & Physiological Optics, 2007.
Zhen Ling Teo, and D. Ting. “AI Telemedicine Screening in Ophthalmology: Health Economic Considerations.” Lancet Global Health, 2023.
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