2014 updated recommendations for preschool vision screening: Guidelines for Filipino children entering the Philippine public school system

@#In 2004, the University of the Philippines Manila published the Philippine Guidelines on Periodic Health Examination (PHEX): Effective Screening for Diseases among Apparently Healthy Filipinos. 1 The document was envisioned to “contribute… to the quality and efficiency of health care and health maintenance for all Filipinos… It was an appeal for rational medical decision-making, and an important step toward “equitable distribution of health and health resources.” The guidelines were prepared by designated task forces, with vision disorders, specifically vision impairment, and glaucoma identified as areas of interest. PHEX recommendations were drafted using standardized principles and a common protocol, with each statement undergoing four phases of development: (1) preparation of the evidence- based draft; (2) en banc meeting that gave panelists a chance to assess and revise the draft, where issues of feasibility, resource limitations, value judgment, and experts’ opinions were taken into account. A consensus was declared when at least 75% agreed on a recommendation; (3) for unresolved issues, modified Delphi technique was employed by correspondence until a consensus was reached or a maximum of three circulations were accomplished. If still unresolved, the issue was labeled as such and included in the final draft; (4) lastly, a public forum was conducted before the final draft was written. In this manner, the recommendations for Screening for Visual Impairment were written by the Task Force for Vision Disorders.

Profile of childhood cataract cases at the Philippine General Hospital

Methods: Case records of all patients seen at the pediatric ophthalmology clinic of UP-PGH from January 1, 2000 to August 31, 2003 were reviewed. Included were patients less than 21 years old diagnosed with cataract not associated with trauma. Cases were classified as to presumptive etiology: idiopathic, familial, or secondary to a systemic or an ocular disorder. Results: The cause of cataract was identified in 37.6 percent of the 218 cases reviewed. Rubella was the leading cause (20.5 percent), followed by suspected rubella infection (8.2 percent). There were 2 cases of varicella and 1 case of cytomegalovirus (CMV) infections. Down syndrome and Lowe syndrome had one case each. Three cases (1.4 percent) were familial. Cataract was idiopathic in 133 cases (61.0 percent). Conclusion: The pattern of childhood cataract in this study is typical of a developing country where rubella infection is the major cause.