Epidemiology of ocular disorders and visual impairment among school pupils in the Cape Coast Metropolis, Ghana

The purpose of the study was to determine the epidemiology of ocular disorders and visual impairment among junior high school children in the Cape Coast Metropolis, Ghana. A cross-sectional study was conducted among junior high school children from both public and private schools. Participants underwent ophthalmic examination that included visual acuity testing, external eye examination, fundus examination, cover testing, and objective and subjective refraction. Socioeconomic statuses of the children were also determined. A principal cause of visual impairment was determined for participants with uncorrected visual acuities of 6/12 or worse in the better eyes. A total of 1252 were enumerated and 1029 children examined. Overall, ocular disorders were found among 104 (10.1%) pupils: refractive errors (37), conjunctival disorders (33), eyelid disorders (5), corneal disorders (4), retinal disorders (4), heterophoria (14), heterotropia (3), and amblyopia (4). Prevalence of visual impairment of 6/12 or worse in the better eye was 47 (4.6%), with refractive error being the major cause accounting for 37 (78.7%). Other causes were amblyopia, 4 (8.5%); retinal disorders, 4 (8.5%); and corneal disorders, 2 (4.3%). By the International Classification of Diseases (ICD) criteria, mild and moderate visual impairment using the better eye was 7.3% and 1.1%, respectively. Visual impairment was not significantly associated with age, gender, or socioeconomic status. Only 209 (20.3%) school pupils had had a previous eye examination, among whom 7 were wearing glasses. Majority (754 [73.3%]) of pupils were within low socioeconomic status (p < .001). The prevalence of eye disorders among junior high school pupils in the Cape Coast Metropolis was high compared to the global estimates. The cause of visual impairment was largely preventable, refractive error being the major cause. Uptake of eye care services among the school pupils was poor as majority of them had never had a previous eye examination. Incorporation of school eye screening programs into the school curriculum is recommended.