Objective: To determine the prevalence of refractive errors and other ocular morbidities among school-aged children in the tribal regions of Central India and assess the effectiveness of school-based screening programs. Methods: A cross-sectional, school-based study was conducted in Chandrapur district, Maharashtra, India, covering 386 government schools. A total of 81,962 students aged 5 to 15 years were screened using a three-tier approach involving ophthalmic assistants, optometrists, and ophthalmologists. Visual acuity testing, cycloplegic refraction, and fundoscopic examination were performed. Statistical analysis was conducted using STATA. Results: A total of 1,874 (2.29%) children were referred for secondary-level screening due to visual impairment. The prevalence of refractive errors was 2.18%, with myopia (1.66%) being the most common, followed by hypermetropia (0.026%) and astigmatism (0.59%). Visual impairment was more common in girls (64%) than in boys (36%). The highest prevalence was seen in 8th-10th grade students (54.48%). Other ocular morbidities included amblyopia (1.55%), vitamin A deficiency (1.87%), squint (0.48%), allergic conjunctivitis (0.53%), and cataract (0.11%). Conclusion: Refractive errors remain a significant cause of visual impairment in school-aged children, particularly among girls. Early screening and intervention in tribal schools can help reduce preventable blindness and improve quality of life. Further efforts are needed to improve access to eye care services in these underserved populations.