Prevalence and distribution of visual impairment, refractive error and their impact on quality of life among school-going children aged 6-18 years in Sekhukhune District (Limpopo), South Africa.

Abstract

Background: Refractive error (RE) and visual impairment (VI) remain major problems affecting school going children worldwide and impacting their quality of life. Aim: To determine the prevalence and distribution of RE and VI, and their impact on quality of life (QoL) of school-going children. Setting: This school-based study was conducted on school-going children residing within the borders of greater Sekhukhune district, Limpopo (South Africa). Methods: A multistage random sampling method was used to select schoolchildren aged between 6 and 18 years from Grades R to 12. A total of 400 learners where invited to participate in this study and 326 (81.5% [95% CI, 77.7-85.3]) learners underwent an eye examination. The examination assessed unaided and aided visual acuity using a LogMAR chart, binocular motor function, autorefraction under cycloplegia, media and fundus examination, and QoL measured with the National Eye Institute visual function questionnaire (NEI-VFQ-25). Results: The prevalence of uncorrected, presenting and best corrected visual acuity of 0.30 or worse in the better eye was 12.3% (95% CI, 8.7-15.8), 12.3% (95% CI, 8.7-15.8) and 2.1% (95% CI, 0.6-3.7) respectively. Refractive error accounted for 81% of all causes of VI. Myopia was the most prevalent RE (50.7% [ 95% CI, 38.8-62.7] ), followed by astigmatism (36% [95% CI, 24.3-47.3]), and hypermetropia (13.6% [95% CI, 5.30-21.6] ). There was no significant difference in the prevalence of RE and VI between males (50.7% [95% CI, 38.8-62.7]) and females (49.3% [95% CI, 37.3-61.2]). Refractive error and VI were highest among children aged between 14 and 18 years. Moreover, the highest prevalence of RE was observed in Grades 9 to 12 learners (46.3% [95% CI, 34.3-58.2]). Children with RE and or VI scored low on NEI-VFQ-25. Conclusion: The prevalence of RE and VI among schoolchildren in greater Sekhukhune district was high. This calls for attention from policymakers and all stakeholders responsible for eye care to devise strategies to address these conditions as they decrease the children’s QoL.