Visual status and prevalence of eye disorders among school-age children in southern Nigeria

Abstract

Aim: This study assessed the types and prevalence of eye problems among school-age children in Cross River State (CRS), Nigeria.

Method: The study design was a cross-sectional analytic survey of 2418 school children aged 6–17 years from seven public and three private schools in CRS, selected using the multistage random sampling technique. Ethical approval was obtained from the Ethical Committee, CRS Ministry of Health, Nigeria. The following tests were carried out on all children enrolled in the study: researcher-administered semi-structured questionnaires, LogMAR visual acuity measurements, external and internal eye examinations, non-cycloplegic auto-refractions, retinoscopy and subjective refractions. Quality assurance was carried out to validate the data collected, and data were analysed using SPSS and EPI info.

Results: A total of 2418 school children were enumerated, and 2110 (87.3%) were examined; 1117 (52.9%) were girls, and 1250 (59.2%) were 6–11 years old, while 860 (40.8%) were 12–17 years old, and 77% attended public schools. The majority, 1895 (89.9%) of the children examined, had never had an eye examination. The prevalence of eye diseases among the school children was 32.1%, and the major causes were conjunctivitis 397 (18.8%; confidence interval [CI] 19.2–13.0), refractive error 243 (11.5%; CI 10.2–13.0), glaucoma suspects 52 (2.5%; CI 1.9–3.2), amblyopia 7 (0.3%; CI 0.0–0.7) and corneal opacity 4 (0.2%; CI 0.1–0.5). Analysis using chi-square tests and logistic regression shows a positive higher association of refractive error in private (16.7%) than public schools (9.9%) (crude odds ratio [COR] 1.8150; adjusted odds ratio [AOR] 1.9129, p < 0.001), higher socio-economic status of parents (COR 2.3402, AOR 1.9819, p < 0.001), older age group (COR 1.7258, AOR 1.8202, p < 0.001) and girls (13.1%) versus boys (9.8%) (COR 0.7200, AOR 0.7144, p < 0.001).

Conclusion: Physical and eye health examination of children before school entry is strongly recommended. The application of 2 D lens for children who fail a standard visual acuity test should be routine during vision screening to ensure that significant refractive errors are not missed.