Evaluate use by health care workers of standardized reference photographs and direct ophthalmoscopy as a lowcost alternative to photographic approaches

As noted in section 5, this approach, involving general health care workers, probably offers an acceptable level of performance, as observed in other areas of eye care delivery (e.g. trachoma). Demonstrating that this is the case will be essential to its widespread adoption and acceptance by the societies and populations that might benefit most from such services. This information will also be necessary to provide the basis for informed decisions about trade-offs between cost and performance.

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