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Background: Uncorrected refractive error (URE) is a major cause of vision impairment in children worldwide. Cases are often detected through a school-based vision screening program and then treated in a follow-up appointment. This requires parents or guardians ('parents') to adhere to referrals for the eye exam and care plan. We aim to understand the reasons for parents' referral non-adherence in Cross River State, Nigeria, using qualitative methods. Methods: Ten focus groups were held with parents who had not adhered to the referral for a follow-up eye examination. Participants were recruited with help from staff in schools hosting the vision screening programme. Interviews were conducted using a semi-structured interview guide, audio taped and transcribed verbatim. After identifying relevant quotes, the researchers labelled each one with a descriptive code/subcode label. Then they clustered the data into categories and overarching themes. Results: Forty-four parents participated in 10 focus group discussions with 28 women and 16 men. Three themes and participated in the focus group discussions with 28 women (63%). Twelve themes were generated. The three megathemes were Modifiable Factors (with 4 themes), Contextual Factors (with 6 themes), and Recommendations (with 2 themes). Conclusion: Participants identified modifiable barriers that make it difficult for parents to adhere to a referral for a follow-up eye exam. These include not believing their child has a vision problem or the screening test, and issues with the referral letter. They also described important contextual factors such as poverty, logistical problems, parental attitudes towards their children and beliefs about appropriate care. Many of these issues could be addressed by following their recommendation to educate the public on the importance of child eye care and correct parents' misconceptions. These themes will be used by the Nigerian government to enhance and scale up its child eye health programme. [ABSTRACT FROM AUTHOR]

Background. Vision is critical in the development and performance of children. Factual knowledge of eye health is important for preventive and promotive eye health. Objectives. To identify eye health myths and misconceptions that are considered true in a population of Nigerian school children, with the aim of prioritizing eye health messages. Material and methods. In a cross-sectional survey, self-administered questionnaires were used to obtain pupils' views, which were elicited using statements presented as 22 ocular health myths/misconceptions and three facts in two selected secondary schools in Enugu state, Nigeria in October 2014. Frequency counts and percentages were generated using SPSS v18. A p-value of < 0.05 was considered statistically significant. Results. The sample comprised 404 males (48.5%) and 429 females (51.5%), age range 10-17 years, median 13-14 years; IQR -6). More pupils in the senior classes had previously listened to eye health talks. The most common beliefs concerned the statements "staying close to the television set will damage vision" 782 (93.9%), and "reading in dim light will damage vision" 758 (90.8%). The least commonly-held misconception was "children do not need regular eye checks" 119 (14.3%). The greatest amount of uncertainty concerned the statements "short-sightedness is worse than long-sightedness" 421 (51%), and "crossed-eye disorders cannot be corrected in children" 383 (46%). Conclusions. The majority of the children do not have information on eye health. Despite the persistence of these myths and misconceptions, this study has demonstrated that the children had a reasonable level of knowledge in terms of safe eye care practices. However, appropriate eye health messages still need to be provided. [ABSTRACT FROM AUTHOR]