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To determine the prevalence refractive errors and causes of visual impairment in school children in the south-eastern region of Nigeria. School-based cross-sectional samples of children 5 to 15 of age in both urban and rural areas were profiled through cluster sampling. The main outcome measures were presenting, uncorrected, and best-corrected visual acuity using the Refractive Error in School-age Children (RESC) protocol. A total of 5723 children were examined during the study period comprising 2686 (46.9%) males and 3037 (53.1%) femal