A community health worker is trained to screen for eye diseases in a rural area under the NPCBVI framework. She uses the 'E' chart at 6 metres and a torch for external eye examination. According to NPCBVI guidelines, which of the following findings should she refer to the nearest Vision Centre or Primary Health Centre for further evaluation?

• A Visual acuity of 6/9 in both eyes
• B Visual acuity of 6/18 in one eye in a 60-year-old
• C Mild conjunctival congestion with watery discharge
• D White reflex in the pupil of a 2-year-old child ✓

Explanation

Leukocoria (white reflex in the pupil) in a child is a red flag finding requiring urgent referral, as it may indicate retinoblastoma, congenital cataract, or retinopathy of prematurity. Under NPCBVI community screening protocols, this is a mandatory referral criterion. Visual acuity of 6/9 is within normal limits. Mild conjunctival congestion suggests self-limiting conjunctivitis. VA of 6/18 in a 60-year-old, while warranting refraction evaluation, is not as urgent as leukocoria.

Reference: Park's Textbook of Preventive and Social Medicine, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.