Uncorrected Refractive Errors and Academic Performance among Primary School Children in Abakaliki, Southeast Nigeria: A Comparative Cross-sectional Study

Abstract Background: Uncorrected refractive error (URE) is the leading cause of visual impairment worldwide. Poor vision resulting from URE can adversely affect the academic performance of school-aged children. Objective: The objective of the study was to compare the academic performance of primary school children with UREs to that of children without refractive errors (REs) in Abakaliki, Ebonyi State, Nigeria. Materials and Methods: A school-based comparative cross-sectional study was conducted among primary school children in public and private schools in Abakaliki metropolis. Visual acuity was assessed using the Snellen chart, and children with URE were identified. Academic performance was evaluated based on average scores and categorized as high (≥75%), average (50%–74%), or low (<50%). The study included 115 children with URE and 115 age-, gender-, and class-matched controls without REs from the same schools. Data were analyzed using appropriate statistical tests, with P < 0.05 considered statistically significant. Results: The mean academic score was significantly lower among children with URE (50.1 ± 7.0) than those without REs (55.8 ± 5.9, P = 0.001). Among children with URE, 48 (41.7%, 95% confidence interval [CI]: 32.6–51.3) had average academic performance, compared with 102 (88.7%, 95% CI: 81.5–93.8) of children without REs ( P < 0.001). Low academic performance was observed in 67 (58.3%) children with URE versus 13 (11.3%) controls ( P < 0.001). Conclusion: UREs are significantly associated with lower academic performance among primary school children. Routine vision screening in schools is recommended to facilitate early detection and intervention, thereby supporting educational outcomes.