Screening for uncorrected refractive error in secondary school‐age students in Fiji

Background:  To estimate the rate of uncorrected refractive error and the associations with gender, age, ethnicity and place of residence. Design:  Population-based study. Participants:  Secondary school students in the Central Division of Fiji. Methods:  All 58 secondary schools in the Central Division of Fiji were invited to participate and one class per year level at each participating school was randomly selected for screening. Visual acuity was tested using a logMAR chart and pinhole. Outcomes of screening included normal vision, corrected refractive error, uncorrected refractive error (VA <6/12 and improvement to ≥6/12 with pinhole (myopia) or hyperopia (tested with +2.00-D lens) and low vision (corrected VA <6/18). Main Outcome Measure:  Prevalence of uncorrected refractive error. Results:  The participation rate of schools was 91% with 8201 students aged 12–20 years; 8021 students had normal vision; 180 had impaired vision (166 refractive error and 14 low vision). The rate of refractive error was 2.0% (95% CI: 1.7–2.3). Indian students were nearly 6 times more likely (OR: 5.89; 95% CI: 4.17–8.34; P < 0.001) to have refractive error than Fijians. The rate of uncorrected refractive error was 0.9% (95% CI: 0.7–1.1) in Fijian students (OR: 2.89; 95% CI: 1.37–6.10; P = 0.01) and those living in rural areas (OR: 3.28; 95% CI: 1.32–8.16; P = 0.01) were more likely to have uncorrected refractive error. The rate decreased by 20% (95% CI: 4.0–33.0) with each year of increasing age. Conclusion:  The prevalence of uncorrected refractive error in children is relatively low in Fiji with higher rates in Fijian and rural children.