In school-based vision screening programs, the Snellen chart is used for visual acuity testing. A child scores 6/12 on the right eye and 6/18 on the left. According to the referral criteria in Indian school eye screening programs, this child should be:

• A Referred only for the left eye (VA < 6/12 unilaterally)
• B Referred for complete ophthalmic evaluation of both eyes ✓
• C Not referred — both eyes have acuity ≥6/18 which is normal for children
• D Given spectacles empirically without further examination

Explanation

In school eye screening programs under NPCBVI, any child with visual acuity less than 6/9 in either eye (some programs use <6/12 as the cut-off) should be referred for complete ophthalmic examination including cycloplegic refraction. Since both eyes here are below 6/9 (6/12 and 6/18), referral for both eyes is warranted. The threshold for referral in most Indian school screening programs is VA ≤6/12 in either eye. Empirical spectacles should never be given without proper refraction, especially in children where cycloplegic refraction is essential.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

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