To address the global burden of avoidable blindness, eye care systems must determine optimal strategies for identifying people with or at risk for visual impairment beyond opportunistic screening. After cataract and uncorrected refractive error, the leading causes of visual impairment globally are glaucoma, diabetic retinopathy (DR), corneal opacity, and age-related macular degeneration (AMD). Glaucoma, DR, and AMD are theoretically amenable to screening as they are treatable and initially asymptomatic. Mass screening for eye disease is currently not recommended as prior studies have been unable to demonstrate that screening improves visual acuity in the community. However, the available evidence is largely from resource-rich settings and limited by small sample sizes and considerable loss to follow-up.

The Village Integrated Eye Worker Trial II is a cluster-randomized trial that builds on the infrastructure developed for the first Village Integrated Eye Worker Trial (VIEW) to assess the effectiveness of a community-based screening program employing optical coherence tomography, intraocular pressure measurement, and enhanced linkage-to-care in reducing visual impairment in Nepal. To isolate the effect of screening for glaucoma, DR, and AMD, cases of cataract and refractive error are identified identically in both study arms during a baseline census. This study is funded by the National Eye Institute (UG1EY028097).

For more information, the complete Manual of Procedures, Statistical Analysis Plan, and data sharing statement are available at https://osf.io/fgvrt/.