Review Article

Vision problems: A review of prevalence studies on refractive errors in school-age children

Uchenna C. Atowa, Rekha Hansraj, Samuel O. Wajuihian
African Vision and Eye Health | Vol 78, No 1 | a461 | DOI: | © 2019 Uchenna C. Atowa, Rekha Hansraj, Samuel O. Wajuihian | This work is licensed under CC Attribution 4.0
Submitted: 24 May 2018 | Published: 09 May 2019

About the author(s)

Uchenna C. Atowa, Discipline of Optometry, University of KwaZulu-Natal, Durban, Saudi Arabia
Rekha Hansraj, Discipline of Optometry, University of KwaZulu-Natal, Durban, South Africa
Samuel O. Wajuihian, Discipline of Optometry, University of KwaZulu-Natal, Durban, South Africa


Background: Refractive errors are common eye disorders and are leading causes of visual impairment in the general population. Children with uncorrected refractive error may experience reduced visual acuity, transient blurring, headache and persistent ocular discomforts particularly for close work which can impair reading efficiency and school performance.

Aim: This article documents the prevalence of refractive errors in school-age children of different ethnic origins. The goal is to identify possible variation in measuring techniques and diagnostic criteria, as well as limitations of studies, to provide a clear direction for future studies.

Methods: The review was undertaken through a detailed evaluation of peer-reviewed publications of primary research on this topic. The keywords for the search included ‘refractive error’, ‘hyperopia’, ‘myopia’, ‘astigmatism’ and ‘school children’. Only epidemiological studies with participants between 5 and 18 years of age were included.

Results: Although several population and school-based studies have been conducted in various racial groups and populations, their findings were diverse owing to inconsistencies in the methods applied in identifying children in need of refraction, measurement techniques and diagnostic criteria for refractive errors. There are also some limitations associated with the sampling design and characteristics, which may have influenced the outcome measures.

Conclusion: Despite the problems inherent in the studies, the review indicates that refractive error in school-age children is a public health concern in those populations and warrants additional research that will provide reliable data for proper planning of intervention strategies.


hyperopia; myopia; astigmatism; school-age children; school performance


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