Visual impairment and refractive error amongst school-going children aged 6-18 years in Sekhukhune District (Limpopo, South Africa)

Background: Refractive error (RE) and visual impairment (VI) remain major problems affecting school-going children worldwide. Aim: To determine the prevalence and distribution of VI and RE in school-going children aged 6-18 years. Setting: The study was conducted in Sekhukhune District, Limpopo, South Africa. Methods: A multistage random sampling method was used to select school-going children aged 6-18 years from Grades 1 to 12. A total of 326 learners went through eye examinations, which included visual acuity (VA) measurement using a logarithm of the minimum angle of resolution chart, autorefraction under cycloplegia and ocular health assessment. Results: The prevalence of uncorrected, presenting and best-corrected VA of 0.30 M or worse in the better eye was 12.3% (95% confidence interval [CI], 8.70-15.80), 12.3% (95% CI, 8.70-15.80) and 2.1% (95% CI, 0.60-3.70), respectively. Refractive error accounted for 80% (95% CI, 67.6-92.4) 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 higher amongst children aged 14-18 years: 56.7% (95% CI, 44.9-68.6) and 60% (95% CI, 44.8-75.20), respectively. Conclusion: The prevalence of RE and VI amongst school-going children in Sekhukhune District was high, highlighting the need for school visual screening and strategies to address these conditions in that area.