Dear Editor,I read with interest an article by Rustagi, et al. on Screening for visual impairment: Outcome among school children in a rural area of Delhi.[1] I congratulate the authors for bringing out myths about the non-use of glasses, but am concerned about the non-compliance of the study subjects and have a few suggestions.The authors should have obtained consent from the parents before the initial examination was done. Identifying the students with visual acuity <20/30 and then obtaining consent from the parents for a refraction test consumed time and built up the non-compliance. This was evident from the fact that 18 students (25.0%) stated that they had forgotten to get the consent form signed and five (6.9%) stated that they had lost the consent forms. Parental involvement from the beginning of the study, for education regarding ocular problems and importance of spectacle use would have helped to improve the compliance. An ophthalmologist's help from the beginning, for performing refraction, would also have helped, as students need not have been referred for refraction to some other place.Ten (0.9%) children had visual acuity <20/200 in the better eye (visual acuity equivalent to blindness, according to the definition of blindness by the National Program for Control of Blindness in India). What was the visual status of these children? I think the authors should have studied the other causes of visual impairment (the first objective of the study) in such a big screening program.