The Basic Eye Screening Test (BEST) for primary level eye screening by grassroot level workers in India.

Dear Editor,

Ten out of every hundred people have problems with their distance vision and half of those over 40 years have near vision impairment.[123]“Basic Eye Screening Test (BEST)” was developed to equip the grass-root level health workers to perform basic primary eye screening right at the doorsteps in the community. It is low-cost, quick, takes only 2–3 minutes, and acts as a triage for referrals to higher levels of care. Specifically, useful for mass community screening programs, it not only helps to estimate the burden of both distance and near vision loss but also provides information about gross external eye disorders such as pterygium, obvious corneal scar, etc.

BEST Tool kit: (1) BEST screening card [Fig. 1] consists of Distance vision portion: Three E optotypes corresponding to 6/60 and five E optotypes corresponding to 6/12, Near vision portion: Has five tumbling E optotypes corresponding to N8, (2) Standard measuring tape of 150 cm length and (3) Torchlight.

Figure 1

The Basic Eye Screening Test vision chart

Human Resources: The BEST protocol can be used by ASHA (Accredited Social Health Activist), Auxiliary Nursing Midwifery (ANM) and other grass-root level health workers after two hours of training.

Protocol: The BEST protocol is done with the subject wearing spectacles under good lighting conditions. It has four simple steps as shown in Fig. 2.

Figure 2

The Basic Eye Screening Test protocol flowchart

The BEST protocol was successfully used in a large state-wide universal eye screening program “Telangana Kanti Velugu”, an initiative by the Government of Telangana. Over 15 million people across all the districts in the Telangana state were screened by ASHA and allied health workers using the BEST protocol. The BEST protocol can be included in the training for ASHA and other allied grass-root level health workers in India.

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Conflicts of interest

There are no conflicts of interest.