D.I. Aniemeka1, E. Ezeanosike1, C.E Ogbonnaya1, C.M. Chuka-Okosa1, A.S Adeke2, A.N. Onyebuchi3, F.N. Odini4

  1. Dept. of Ophthalmology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State.
  2. Dept. of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State.
  3. Department of Radiology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State.
  4. Department of Community Medicine, Federal Medical Center Umuahia, Abia State.


Background: Schoolteachers who have knowledge on eye diseases can detect early children with eye disorders and refer them promptly to an eye specialist. The aim of this study is to assess the effectiveness of teachers in a vision screening program for primary school children in Abakaliki.

Methods: This descriptive cross-sectional study was conducted among 20 randomly selected primary schoolteachers in Abakaliki to screen for vision abnormalities and detect eye problems among 350 children from 5 schools. Teachers participated in a 2-day training using a modified training algorithm on vision screening using a Snellen’s chart and in the identification of common ocular abnormalities. Data was analysed using IBM SPSS version 26 statistical program and a p-value of <0.05 at 95% confidence level was statistically significant.

Results: A total of 379 children were enrolled into the study however, 350 (92.3%) children participated in the study. School teachers correctly identified 283 (92.8%) children who had normal vision and 33(73.3%) who had impaired vision. Overall 60 (17.1%) children with perceived eye defects were referred to the ophthalmologist for re-examination. Refractive error and allergic conjunctivitis were the most common eye problems identified and children with refractive error and other ocular morbidity were referred to the base hospital.

Conclusion: Teachers are a valuable resource in the detection of eye disorders among school children. Their effectiveness can be further enhanced by regular training, and collaboration with eye care professionals. Addressing these limitations through policy implementation can lead to better eye health outcomes for school children in Nigeria.

Keywords: Visual acuity, Eye disorders, Refractive error, School vision screening, Teachers


Dr. D.I. Aniemeka
Department of Ophthalmology,
Alex Ekwueme Federal University
Teaching Hospital,
Abakaliki, Ebonyi State.
Email: dilianiemeka@gmail.com
Submission Date: 18th April, 2023
Date of Acceptance: 30th Dec., 2023
Publication Date: 30th Jan., 2024


Globally, there are at least 2.2 billion individuals who experience either near or distant vision impairment and approximately 1 billion of these vision impairment could have been avoided or have not yet been adequately addressed. The primary causes of vision impairment and blindness worldwide are refractive errors and cataracts1. The estimate of 1 billion likely underestimates the actual number of children with vision impairment, mainly due to limited data on prevalence and causes in child populations.1Available data shows that globally, an estimated 19 million children have vision impairment and 12 million of these children have visual impairment caused by refractive error, while 1.4 million have irreversible blindness, requiring access to vision rehabilitation services to optimise function and reduce disability.2

Population-based studies in Nigeria show that 6.1% – 26% of school aged children aged 6-16 years have visual impairment, with uncorrected refractive error being a significant cause.3–7 There is an existing policy by the Nigerian Ministry of Health on school eye health program that recommends periodic eye screening of school children; however, implementation has not been very effective8. This may be a result of insufficient trained human resources, poor distribution of resources for eye care and limited access to quality eye care services in low- and middle-income countries like Nigeria.9,10 Due to lack of adequate rehabilitative services, children who have severe visual impairment and blindness may not be able to attend school which may lead to high drop-out rates11. The impact of visual impairment and blindness in this population is well documented and can be challenging in the child’s development’s physical, social, economic, and psychological well-being.12–14 It is, therefore, critical to develop strategies to improve the eye health of school children,’and prevent causes of visual impairment and blindness.

School teachers can play major roles in school eye health programs. Their role in implementing these programs is vital as school children spend most of their awake hours with the teachers to get educated.15,16 Community-based innovative strategies such as training teachers in vision screening of school children should be promoted for early detection and prompt referral of school children with ocular morbidity. There is a need to develop this approach to utilise the existing workforce to achieve more comprehensive coverage of eye health services, especially in this age group. The aim of this study is to assess the effectiveness of training school teachers to screen for vision problems in primary school children in Abakaliki, Ebonyi State, Nigeria.