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Unilateral or asymmetric astigmatism is considered a principal refractive error leading to amblyopia and regular eye examinations should be carried out during childhood to prevent visual impairment. The aim of this study was to evaluate the prevalence of astigmatism and spectacle wear among Polish schoolchildren. A cross sectional study was carried out in children aged 6 to 14 years old from 50 schools in Poland. The presence of astigmatism was assessed by non-cycloplegic autorefraction, and defined as a cylinder equal or greater than 0.75 D. Children were classified as living in urban or rural areas according to the school location. Spectacle wear was defined as having spectacles at school. The study included 1041 children and 52.3% were girls ( n  = 544). The mean age was 8.62 ± 2.04 years. The prevalence of astigmatism was 7.3% (95% confidence interval [CI]: 5.8–9.1%). Only 21.7% of children with astigmatism wore spectacles at school. Astigmatism was diagnosed in 8.2% of boys (95% CI: 6.0–11.0%) and 6.4% of girls (95% CI: 4.5–8.8%;  p  = .13); cylindrical anisometropia was present in 19/76 (25.0%) of children with astigmatism (95% CI: 15.8%–36.3%). Against-the-rule astigmatism was the most common; it was observed in 48.7% of children with astigmatism, followed by with-the-rule astigmatism (44.7%) and oblique astigmatism (6.6%). The prevalence of astigmatism was not linearly correlated with age ( r  = 0.24;  p  = .53). Gender, age and place of living were not significantly associated with the presence of astigmatism. This study reports a low prevalence of astigmatism in Polish school children. However, the majority of children with astigmatism were uncorrected. Further longitudinal studies are warranted.

The Prevalence of Astigmatism and Spectacle Wear in Polish Schoolchildren