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Prevalence and Predictors of Refractive Error and Spectacle Coverage in Nakuru, Kenya: A Cross-Sectional, Population-Based Study


Andrew Bastawrous, Wanjiku Mathenge, Allen Foster, Hannah Kuper


British Council for the Prevention of Blindness (BCPB) and the Fred Hollows Foundation




International Ophthalmology


  • A cross-sectional study was undertaken in Nakuru, Kenya to assess the prevalence of refractive error and the spectacle coverage in a population aged ≥50 years.

  • Of the 5,010 subjects who were eligible, 4,414 underwent examination (response rate 88.1 %).

  • LogMAR visual acuity was assessed in all participants and refractive error was measured in both eyes using a Topcon auto refractor RM8800. Detailed interviews were undertaken and ownership of spectacles was assessed.

  • Refractive error was responsible for 51.7 % of overall visual impairment (VI), 85.3 % mild VI, 42.7 % moderate VI, 16.7 % with severe VI and no cases of blindness.

  • Myopia was more common than hyperopia affecting 59.5 % of those with refractive error compared to 27.4 % for hyperopia. High myopia was also more common than extreme hyperopia.

  • Of those who needed distance spectacles (spectacle coverage), 25.5 % owned spectacles.

  • In conclusion, the oldest, most poor and least educated are most likely to have no spectacles and they should be specifically targeted when refractive services are put in place.