Vision Screening in School Children in a Rural Area of Kano State, Nigeria

Abstract

Visual impairment among school-age children is a significant but preventable public health issue, particularly in rural areas with limited eye health programs. This study assessed its prevalence and screening outcomes among school children in Gabasawa LGA, Kano State, Nigeria. A cross-sectional descriptive study was conducted among 422 pupils aged 6–18 years (mean years), selected by multistage stratified random sampling from six public schools spanning primary, junior secondary, and senior secondary levels. All pupils underwent standardized vision screening comprising distance visual acuity testing, pinhole assessment, external ocular examination, corneal light reflex test, and direct ophthalmoscopy. An unaided VA of  in either eye constituted a screening failure and triggered pinhole testing. Improvement with the pinhole indicated probable refractive error and prompted referral for detailed refractive evaluation (Phase 2). Visual impairment was classified using ICD-11 criteria. Out of the 422 pupils, 21 (5.0%) failed vision screening. Visual impairment was detected in 18 pupils (4.3%). Critically, 98.8% of pupils had never undergone a prior eye examination and none were wearing spectacles at the time of screening. These findings demonstrate a substantial undetected burden of visual impairment in this rural population and provide the evidence base for implementing a sustainable school eye health programme in Gabasawa LGA and comparable settings across Kano State. Routine school-based vision screening should be implemented in rural areas, along with access to affordable eye care for early detection and management of visual impairment.