Author’s Disclosure Block: Mohamed Gemae: none; Delan Jinapriya: none; Yi Ning J. Strube: none; Emeka Nzekwu: Dr. Emeka Nzekwu is the CEO and founder of Nation’s Vision, a portable eyecare team which operates the in-school eyecare program and a partner of Nations Health, a charitable organization dedicated to healthcare equity. 

Abstract Body
Purpose:Uncorrected refractive error (URE) is the leading cause of childhood visual impairment worldwide. There is a paucity of data on of URE in Canada, particularly among priority populations facing health inequity and financial disparity. This study investigated the prevalence of URE in priority schoolchildren through a novel in-school eyecare program in Calgary. Study Design: Cross-sectional study Methods: During the 2023-2024 academic year, 48 schools within the Calgary Catholic and Public school districts participated in an in-school screening eyecare program offered to children from kindergarten to grade 12. Schools were selected, by the districts, based on the degree of financial need within the source communities. Informed consent was obtained from parents/guardians to opt-in the program. Children who had undergone an eye exam within the past year were excluded and advised to return to their local optometrists. All eligible and consented students underwent a comprehensive screening eye exam which included visual acuity, intraocular pressure, auto-refraction, extraocular motility, cover tests, color vision, and further tests, including cycloplegic refraction if needed. Students who failed screening underwent a comprehensive eye exam, performed on-site by a licensed optometrist.Children received low-cost or free eyewear upon parental approval, fitted and dispensed by a licensed optician. Follow-up was conducted to evaluate eyewear acquisition.Primary outcome was prevalence of clinically-significant URE, defined by the following criteria:-Astigmatism: Cylinder >1.5D-Myopia exceeding 1.5D (sphere)-Hyperopia: >3.5D (sphere)-Anisometropia: Difference in spherical equivalent >1.5D between eyes Results: 3707 children participated in the program from September to March, with 1234 children randomly selected based on power calculation. The sample was evenly split between males and females (50%). 39% of children were under 8, 37% were between 8-10 years old, and 25% were over 10 years old.The overall prevalence of clinically-significant URE was 21%, with specific rates of 15% for astigmatism, 6% for myopia; 5% for anisometropia; 1% for hyperopia.Amongst children under 8 years of age, the URE rate was 22%. This age group showed higher rates of clinically-significant hyperopia (1%) and astigmatism (19%) than other groups.Children aged 8-10 had a URE prevalence of 19%, while children older than 10 exhibited the highest rate of URE (24%). The latter age group exhibited the highest rates of myopia (13%) and anisometropia (8%). Conclusion: This study highlights a concerning prevalence of URE among schoolchildren in communities facing financial disparity in Calgary, significantly exceeding previously reported rates in other Canadian regions. These results emphasize the importance of community-tailored initiatives to reduce the impact of URE on childhood development and academic performance.