Abstract:
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.
