{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T23:43:10Z","timestamp":1791243790554,"version":"4.1.0"},"reference-count":46,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0The continuous increase in the prevalence of refractive error (RE) globally, with uncorrected refractive error (URE) having been established as the leading cause of visual impairment (VI) in children, is a public health concern. Previous RE studies in South Africa also indicated a growing prevalence, substantiating the burden on schoolchildren.\nAim:\u00a0To determine the prevalence of URE among high school learners.\nSetting:\u00a0No-fee-paying high schools in the Free State, South Africa.\nMethods:\u00a0A school-based cross-sectional study design was conducted on 13- to 19-year-old learners through a multistage stratified random method. The examination included an unaided logarith of the minimum angle of resolution (LogMAR) visual acuity test, binocular motor alignment tests, ocular health assessment and cycloplegic autorefraction.\nResults:\u00a0A total of 868 learners consented to participate in this study, with a mean age of 16.4 \u00b1 1.7 years. Male participants accounted for 34.5% (n\u00a0= 299), while female participants accounted for 65.6% (n\u00a0= 569), with the majority being Grade 10 learners. The prevalence of URE stood at 27.1% (n\u00a0= 233), with astigmatism being the most prevalent ametropia, accounting for 22.3% (192 cases), followed by myopia at 15.1% (n\u00a0= 130) and hyperopia at 5.4% (n\u00a0= 46).\nConclusion:\u00a0A high prevalence of URE, especially among older participants, was established, prompting an urgent concerted intervention from all stakeholders to curb the scourge.\nContribution:\u00a0This study accentuates the visual situation of vulnerable learners, that is, older children from disadvantaged backgrounds in the Free State, which until this point had not been established.<\/jats:p>","DOI":"10.4102\/phcfm.v17i1.4967","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T09:02:40Z","timestamp":1758790960000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Prevalence of uncorrected refractive error in low-resource high schools in the Free State, South Africa"],"prefix":"10.4102","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9886-544X","authenticated-orcid":false,"given":"Xolani","family":"Nyathela","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04qzfn040","id-type":"ROR","asserted-by":"publisher"}],"name":"University of KwaZulu-Natal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1692-2048","authenticated-orcid":false,"given":"Urvashni","family":"Nirghin","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04qzfn040","id-type":"ROR","asserted-by":"publisher"}],"name":"University of KwaZulu-Natal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8732-4096","authenticated-orcid":false,"given":"Naimah","family":"Ebrahim Khan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04qzfn040","id-type":"ROR","asserted-by":"publisher"}],"name":"University of KwaZulu-Natal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Magakwe TSS, Xulu-Kasaba ZNQ, Hansraj R. 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