Refractive errors, visual impairment and utilization of spectacles among primary school children in Onitsha, Anambra State, Nigeria.

Abstract

Aim: To establish the visual status and utilization of spectacles among primary school children in Onitsha, Anambra State, Nigeria. Methods: A stratified random cluster sampling procedure was used to select children aged 5- 15 years old from grades 1 to 6 in primary schools, with 1020 children in 102 clusters being enumerated, of whom 998 (97.8%) were examined. The examination included visual acuity, retinoscopy, auto-refraction under cycloplegia, and examination of the anterior segment, media and fundus. Results: The 998 children consisted of 554 (55.5%) females and 444 (44.5%) males, with their mean age being 9.01± 2.5 years. The prevalence of uncorrected, presenting and best corrected visual acuity of 20/40 or worse in the better eye was 9.7%, 7.7% and 1.3% respectively. Refractive error accounted for 86.6% of all causes of visual impairment (best corrected visual acuity of 20/40 or worse in the better eye). Myopia was the most prevalent refractive error (46.4%), followed by astigmatism (36.1%) and hyperopia (17.5%). Myopia (of at least −0.50 D) in one or both eyes was present in 46.4% of the children when measured with retinoscopy, and 49.5% when measured with auto-refraction. Astigmatism (of –0.50DC or less) was present in 36.1% of the children when with retinoscopy and auto-refraction. Hyperopia (+2.00D or more) in at least one eye was present in 21.6% of children with auto-refraction and 17.5% with retinoscopy. Refractive error and visual impairment were significantly more prevalent in females than in males (P = 0.04).Refractive error was highest among children 11−13 year old, while visual impairment was highest among children 5−7 years old. The rate of wearing spectacles among children with visual acuity of 20/40 or worse in one or both eyes was 20.6%. The major reason for non-compliance with spectacle wear among the children was disapproval from their parents. Conclusion: The prevalence of refractive error and visual impairment among primary school children in Onitsha was high while spectacle utilization rate was low. This highlights the need for services and strategies to address refractive error, visual impairment and compliance with spectacle utilization in this region.