Prevalence of Refractive Errors in School-Aged Children: A Vision Screening and Community Medicine Approach

Background: In low-resource areas, where frequent eye checks are not common like in other parts of the world, refractive errors rank among the most prevalent causes of avoidable childhood visual impairment. Vision screening programs in schools suggest a fundamental platform of early detection and correction. The purpose of this study was to evaluate the distribution and spectrum of refractive errors in schoolchildren and to highlight the significance of ophthalmic screening conducted in the community in primary preventive health care. Methods: The descriptive cross-sectional study was conducted between March and July 2024 in coordination with local government schools and the Department of Community Medicine. Stratified random sampling was used to select 1200 children aged 6-16 years in urban and rural schools. Visual acuity was performed by trained optometrists on the Snellen chart, with retinoscopy, and subjective refraction in patients with VA of less than 6/9. SPSS version 26.0 was used to analyze data. The chi-square and ANOVA tests were used to determine associations between refractive errors and demographic variables. Results: Among 1200 children, 186 (15.5%) had refractive errors. Most prevalent refractive error types were myopia (110 (59.1%)), astigmatism (45 (24.2%)), and hyperopia (31 (16.7%)). The prevalence was higher in urban children (p = 0.003) and in children aged 13-16 years (p = 0.001). Conclusion: The prevalence of uncorrected refractive errors among school-going children is significant and mostly undiagnosed. Primary healthcare strategies that incorporate regular screening at schools should be implemented to prevent unnecessary visual disability and improve educational outcomes.