Prevalence of refractive error among school children in the Cape Coast Municipality, Ghana

Uncorrected refractive errors continue to remain a public health problem among different population groups. Among school children, it has a considerable impact on learning and academic achievement especially in under-served and under-resourced communities. There is a dearth of information about the magnitude of the problem in Ghana. A school based cross-sectional study was carried out to estimate the prevalence and distribution of refractive error among school children in the Cape Coast Municipality of Central Region of Ghana. A total of 1103 school children were enumerated out of which 961 underwent a full eye examination. The children were aged between five and 19 years (mean = 10.5 +/- 3.4 years, 95% confidence interval [CI]: 10.3-10.7). Cycloplegic refraction was performed on each child who failed the reading test. Hyperopia was defined as spherical power of >=+2.00 diopters sphere (DS), myopia as <=-0.50 D and astigmatism as a cylindrical power of <=-0.50 D. Of the children examined, only 0.6% had previously had an eye examination. The prevalence of low vision and blindness in the study population was 0.9% (95% CI: 0.881-0.919) and 0.1% (95% CI: 0.081-0.119) respectively. 25.6% (95% CI: 22.84-28.37) of the children examined had refractive errors. This comprises of 44 (4.6%; 95% CI: 3.3-5.9) hyperopia, 66 (6.9%; 95% CI: 5.3-8.5) myopia and 135 (14.1%; 95% CI: 11.9-16.3) astigmatism of the 957 children examined. The study concludes that uncorrected refractive error is a common cause of visual impairment among school children in the municipality. A low uptake of eye care is also noted in the study. The study therefore recommends the education authority, in collaboration with the District Health Directorate, institutes appropriate measures to ensure compulsory eye examination for school children in the Cape Coast Municipality.