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Updated: Sep 25, 2026
Subjective Refraction Test Using a Smartphone for Vision Screening
Published on: October 18, 2024
A survey of the prevalence of refractive errors among children in lower primary schools in Kampala district
1Department of Ophthalmology, Makerere University, Kampala, Uganda.
Insights
Refractive errors affect approximately 12% of young Ugandan school children, impacting their education. Early vision screening is crucial to detect and manage these common vision impairments in children.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Public Health
Background:
- Refractive errors are a leading cause of visual impairment globally, significantly affecting children's academic progress.
- Limited data exists on the prevalence of refractive errors among African children.
- Uganda lacks a systematic vision-screening program for children entering school.
Purpose of the Study:
- To determine the prevalence of refractive errors in primary school children in Kampala, Uganda.
- To identify the types of refractive errors and their distribution.
- To explore potential relationships between refractive errors and ethnicity or sexuality.
Main Methods:
- A cross-sectional descriptive study was conducted in Kampala district, Uganda.
- Visual acuity testing was performed on 623 children aged 6–9 years.
- Prevalence was calculated for significant refractive errors (+/-0.50 or worse).
Main Results:
- A prevalence of 11.6% for significant refractive errors was found in the studied population.
- Astigmatism was the most common refractive error, accounting for 52% of cases.
- Hypermetropia was the second most frequent, while myopia was least common.
Conclusions:
- Approximately 12% of primary school children (aged 6–9) in Kampala exhibit significant refractive errors.
- Regular vision testing at school entry is recommended to identify children with visual impairments.
- Early detection and intervention are vital to prevent long-term vision problems and educational setbacks.
Background:
Refractive errors are a known cause of visual impairment and may cause blindness worldwide. In children, refractive errors may prevent those afflicted from progressing with their studies. In Uganda, like in many developing countries, there is no established vision-screening programme for children on commencement of school, such that those with early onset of such errors will have many years of poor vision. Over all, there is limited information on refractive errors among children in Africa.
Objective:
To determine the prevalence of refractive errors among school children attending lower primary in Kampala district; the frequency of the various types of refractive errors, and their relationship to sexuality and ethnicity.
Design:
A cross-sectional descriptive study.
Setting:
Kampala district, Uganda
Patients:
A total of 623 children aged between 6 and 9 years had a visual acuity testing done at school using the same protocol; of these 301 (48.3%) were boys and 322 (51.7%) girls.
Results:
Seventy-three children had a significant refractive error of +/-0.50 or worse in one or both eyes, giving a prevalence of 11.6% and the commonest single refractive error was astigmatism, which accounted for 52% of all errors. This was followed by hypermetropia, and myopia was the least common.
Conclusion:
Significant refractive errors occur among primary school children aged 6 to 9 years at a prevalence of approximately 12%. Therefore, there is a need to have regular and simple vision testing in primary school children at least at the commencement of school so as to defect those who may suffer from these disabilities.
