Refractive error, amblyopia and ocular alignment among schoolchildren in Saudi Arabia.

Background: Refractive errors (REs) and amblyopia are the leading causes of visual impairment (VI) in children worldwide; however, national data for Mexico are scarce. Objective: We aim to estimate the clinical prevalence of RE, refractive amblyopia, and associated visual impairment (VI) in Mexican children aged 6-12 years. Methods: We analyzed 784,372 non-cycloplegic eye examinations from Salud Digna outpatient clinics across all 32 Mexican states (2021-2025). REs were classified as myopia (≤-0.50 D), hyperopia (≥+2.00 D), or astigmatism (≤ -1.00 D cylinder). Refractive amblyopia was defined as best-corrected visual acuity ≤ 20/30 in the most affected eye. The VI categories followed the WHO criteria. Results: Myopia was the most frequent (43.86%), followed by astigmatism (38.41%) and hyperopia (1.29%). Refractive amblyopia affected 4.94% of the children, predominantly due to astigmatic isoametropia (72.19%). VI related to refractive amblyopia occurred in 1.20% (mild), 0.37% (moderate), 0.01% (severe), and 0.01% (blindness) of children. Men showed a higher prevalence of RE and refractive amblyopia (p < 0.01). Geographic disparities were evident, with the central and southern states reporting the highest RA rates. Conclusions: Our outpatient-based study underscores REs, refractive amblyopia, and astigmatic ametropia as significant public health concerns in Mexican school-aged children. The high prevalence of uncorrected REs and refractive amblyopia highlights the need for nationwide school-based screening programs and early intervention strategies to mitigate long-term visual and developmental consequences.

Purpose: To characterize the prevalence of refractive error and amblyopia among three- to six-year-old children during the period from 2002 to 2011. Methods: About 31,400 children annually (from 16,592 to 40,816) during the period from 2002 to 2011 were enrolled. The preschool vision screening was performed by the Korean Foundation for the Prevention of Blindness (KFPB) annually during a period that extended from March to September. We reviewed the KFPB annual report about the home vision-screening test as performed during the period from 2002 to 2011. Changes in the prevalence and types of refractive error, strabismus, and amblyopia that manifested throughout this period were analyzed. Results: The prevalence of refractive errors ranged from 1.10% in 2002 to 0.42% in 2011. The prevalence of hyperopia and myopia changed little throughout the 10-year study period. Myopia and hyperopia were equally common among the population examined (χ2-test, p = 0.137). The prevalence of anisometropia decreased over time. The annual prevalence of amblyopia ranged from 0.39% to 0.06%, while the overall prevalence of amblyopia dropped from 0.25% in 2002 to 0.06% in 2011. The prevalence of strabismus was highest in 2006 (0.30%) and had decreased by 0.06% in 2011. The type of strabismus showed no significant difference over time (χ2-test, p = 0.579). Conclusions: The prevalence of amblyopia, refractive error, anisometropia, and strabismus was lower in 2011 than in early 2000. The prevalence of hyperopia and myopia as well as strabismus remained similar throughout the study period.

Some 12.8 million in the age group 5–15 years are visually impaired from uncorrected or inadequately corrected refractive errors. In Saudi Arabia, the size of this public health problem is not well defined especially among primary schoolchildren. The purpose of this cross-sectional study was to assess the prevalence and pattern of refractive errors among primary school children in Al Hassa, Saudi Arabia. A total of 2246 Saudi primary school children aged 6 to 14 years of both genders were selected using multistage sampling method form 30 primary schools located in the three different areas of Al Hassa. School children were interviewed to collect demographics and vision data using a special data collection form followed by screening for refractive errors by trained optometrists within the school premises using a standardized protocol. Assessment of visual acuity and ocular motility evaluation were carried out and cover-uncover test was performed. Children detected with defective vision were referred for further examination employing subjective refraction with auto refractometer and objective refraction using streak retinoscopy after 1% cyclopentolate. Of the screened school children (N=2002), the overall prevalence of refractive errors was 13.7% (n=274), higher among females (Odds ratio, OR=1.39, P=0.012) and significantly more among students of rural residence (OR=2.40, P=0.001). The prevalence of refractive errors was disproportionately more among those aged 12-14 years (OR=9.02, P=0.001). Only 9.4% of students with poor vision were wore spectacles for correction. Myopia was the most commonly encountered refractive error among both genders (65.7% of the total errors encountered). Uncorrected refractive errors affected a sizable portion of primary school children in Al Hassa, Saudi Arabia. Primary schoolchildren especially females, rural and older children represents high risk group for refractive errors for which the included children were unaware.

Prevalence of correctable visual impairment in primary school children in Qassim Province, Saudi Arabia

Background and AimRefractive errors, amblyopia, strabismus, and low vision are more common among children with hearing impairments in comparison with their hearing peers. Neglecting visual disorders can pose educational and social problems for these children. The present study aimed to assess the prevalence of refractive errors, amblyopia, strabismus, and low vision among hearing-impaired and deaf students in Kermanshah.Materials and methodsA total of 79 deaf and hearing impaired students within the age range of 7–20 years (mean age of 15.01 ± 2.72) underwent optometric examinations, including autorefractometry, retinoscopy, ophthalmoscopy, slit lamp, visual acuity measurement, and cover-uncover test. Those who needed further evaluation were referred to the Ophthalmology Clinic of Imam Khomeini Hospital.ResultsRegarding the prevalence of refractive errors, 32 (40.5%) subjects had one or a combination of refractive errors, the most common of which was astigmatism (36.7%), followed by amblyopia (15.1%). The most common type of strabismus was latent strabismus (heterophoria) (88.6%), followed by exophoria (81%). Moreover, 3 (3.7%) cases had nystagmus. A significant difference was observed between the prevalence of amblyopia and the degree of hearing loss (P = 0.026), and no significant difference was detected in other cases.ConclusionAs evidenced by the obtained results, refractive errors, amblyopia, strabismus, and low vision are more prevalent among deaf and hearing-impaired children compared to normal children because deaf and hearing-impaired children are not able to convey their vision problems and need to compensate for their poor hearing with an enhanced sense of sight, inattention to these disorders can present these children with serious educational and social problems. Therefore, eye screening examinations are of paramount importance in deaf and hearing-impaired children.

Prevalence and determinants of refractive status and related ocular morbidity among Indian school children in Riyadh, Saudi Arabia

AIM: To assess the prevalence of uncorrected refractive error (RE) and binocular vision (BV) anomalies in school-aged children in Uyoun Aljawa, a small urban town in Saudi Arabia.&#x0D; &#x0D; METHODS: This was a cross-sectional study of 417 students (aged 6&amp;ndash;13 years old) conducted in two primary schools in Uyoun Aljawa from November 2019 to January 2020. All students underwent comprehensive eye examination that include: distance visual acuity (VA), Non- cycloplegic refraction, ocular alignment assessment with the cover test; Near Point of Convergence (NPC) evaluation, Near stereo-acuity with Titmus-fly Stereotest, and finally, colour vision was screened with Ishihara plates. &#x0D; &#x0D; RESULTS: A total of 417 male schoolchildren (mean age &amp;plusmn; SD: 9.2 &amp;plusmn; 1.9) were included. In this study, 78 (18.4%) students had reduced vision (VA of &amp;le;6/9) of which only 21 (27%) students had spectacles at the time of the study and 19.2% had uncorrected RE (VA of &amp;lt;6/18 and no corrections). Emmetropia was reported in 80.3% of children where hyperopia was the most common refractive error (8.9%) followed by myopia (7.7%), and simple astigmatism was reported only in 3.1%. Heterophoria was reported in 12.5% of the sample, 5.2% had convergence insufficiency, and 16.3% showed subnormal results in stereo-acuity and 11 cases had a colour vision deficiency.&#x0D; &#x0D; CONCLUSION: The results of this study reveal a high prevalence of RE and other BVA among schoolchildren in Uyoun Aljawa. Vision Screening programs of children for RE and BVA should be conducted at the community level and integrated into school health programmes.

Refractive errors lead to visual impairment if they are uncorrected. The prevalence of uncorrected refractive errors in children is considerably high, even though they can be easily corrected with spectacles. To estimate the prevalence of uncorrected refractive errors and investigate their associated factors among school children in suburban areas in Indonesia. This cross-sectional study was conducted among school children aged 11–15 years in randomly selected schools. All students in the selected schools underwent uncorrected, presenting, and best-corrected visual acuity testing. Structured interviews were administered to the parents of children with refractive errors. All associated factors were analysed by multivariate logistics regression. A total of 3035 school children, 1193 boys and 1842 girls, were examined. The prevalence of refractive errors was 15.9% (95% CI: 14.7–17.3), while that of uncorrected refractive errors was 12.1% (95% CI: 11.0–13.4). Lower father’s income was associated with a higher prevalence of uncorrected refractive errors (OR: 1.69; 95% CI: 1.6–2.69; p = 0.26). Worse visual performance (OR:0.38; 95% CI: 0.27–0.55; p = 0.1) and longer distance to primary healthcare services (OR: 0.50; 95% CI: 0.37–0.69; P = 0.1) were associated with a lower prevalence of uncorrected refractive errors. Uncorrected refractive errors were found to be highly prevalent among school children in suburban areas in Bandung Regency. The availability of visual assessment services for children needs to be improved.

Prevalence of refractive errors among pre-school children at King Abdulaziz Medical City, Riyadh, Saudi Arabia

Purpose Refractive errors (REs) are a significant cause of vision impairment and the second leading cause of blindness worldwide. Myopia, hyperopia, and astigmatism are the most prevalent forms. In developing regions, including India, the prevalence and impact of REs, particularly among school-aged children, is profound, affecting their academic performance and overall quality of life. Methods This review aimed to consolidate data from studies published post-2018 to provide updated prevalence estimates of REs among Indian school children. Following the PRISMA guidelines, a comprehensive literature search was conducted in May 2024 across four databases: Web of Science, PubMed, Scopus, and Embase. Inclusion criteria focused on cross-sectional studies from India, reporting the prevalence of REs among school-aged children. Results Out of 1434 studies, 43 met the inclusion criteria. The overall pooled prevalence of REs was 11% (95% CI: 0.08–0.15). The subgroup analysis showed a slight decline in prevalence post-COVID-19, from 12% to 11%. Prevalence was higher in cycloplegic studies at 12%, compared to 10% in non-cycloplegic. Myopia was the most prevalent RE at 8%, with astigmatism at 3% and hyperopia at 1%. No significant gender differences were found. The meta-regression does not indicate a statistically significant relation between the year of publication and the prevalence of RE. Conclusion REs, particularly myopia, pose a significant burden among Indian schoolchildren. Despite the COVID-19 pandemic, the overall prevalence of REs has remained stable. These findings emphasize the need for continued vision screening programs and targeted interventions to reduce the prevalence of uncorrected refractive errors.

Background: Global estimates suggest there are almost 19 million visually impaired children worldwide, the major cause being uncorrected refractive error (RE).Aim: To assess the prevalence of visual impairment (VI) and RE among Sudanese school-aged children.Setting: Eight randomly selected primary schools from 21 districts in South Darfur State of Sudan were involved.Methods: A school-based cross-sectional study of RE and VI in primary schoolchildren from grades 1 to 8 (children aged 6–15 years) was investigated. A Refractive Error Study in Children (RESC) protocol was implemented to determine the prevalence of RE and VI in these schoolaged children. Participants were enrolled through stratified multistage cluster sampling of four all-male and four all-female primary schools from South Darfur State of Sudan. Examination procedures followed the RESC protocol, which included visual acuity (VA) measurements, binocular vision assessments, retinoscopy and autorefraction under cycloplegia, as well as examination of the external eye, anterior-segment, media and fundus.Results: A total of 1775 children were invited to participate in the study and 1678 were examined resulting in a participation rate of 94.5%. The findings indicated that the prevalence of uncorrected, presenting and best-corrected VA of 6/12 or worse was 6.4% (95% confidence interval [CI], 4.9–7.9), 4.4% (95% CI, 2.9–5.9) and 1.2% (95% CI, 0.3–2.7) respectively. RE was the cause of VI in 57% of participants, retinal disorders in 13.1%, amblyopia in 5.6%, corneal opacity in 0.9%, cataract in 3.7%, with the causes of reduced vision undetermined in 10.3% and various other causes contributed 9.3%. External and anterior-segment abnormalities were observed in 10.2% of children. This was mainly allergic conjunctivitis (5.3%) followed by bacterial and viral conjunctivitis (4.2%). The prevalence of myopia (≥|-0.50 D|) in one or both eyes was 6.8% (95% CI, 5.3–8.3), hypermetropia (≥ 2 D) was noted in 1.9% (95% CI, 0.4–3.4) and astigmatism (≥|-0.75 D|) prevailed in 2.5% (95% CI, 1.0–4.0). Prevalence of VI among schoolaged children were associated with the children’s age and grade levels (p = 0.00) but was not correlated with gender (p = 0.224). Prevalence of RE among school-aged children was significantly correlated with age and grade levels (p = 0.00). No significant correlation was found between gender and prevalence of RE (p = 0.833). The prevalence of VI because of myopia was associated with increasing grade levels and also the childhood age (p = 0.023), but there was no significant difference in the prevalence of VI because of myopia between male and female children.Conclusion: Uncorrected RE was a major cause of VI among children in the South Darfur State. There is thus a critical need for developing a comprehensive child eye care plan focusing on the reduction of uncorrected RE through collaboration between key stakeholders and government.

PURPOSE:The purpose of this study was to determine the magnitude and determinants of refractive error (RE) and related ocular morbidities among preparatory and secondary Saudi students in Riyadh.METHODS:This study was conducted in 2017–2018 at preparatory (12–14 years) and secondary (15–18 years) schools. A “Spot Screener” was used to determine if the child passed or failed a refraction test. Fail test meant RE ≥ ± 0.50 D. Data were collected on refractive status in each eye, anisometropia, and strabismus. The type of RE was estimated and analysis was performed for an association to gender, age, and education levels. The use of spectacle while screening defined the compliance of spectacle wear.RESULTS:The study sample was comprised of 708 Saudi students. There were 59.5% of boys. The prevalence of RE was 43.6% (95% confidence interval [CI]: 40.0, 47.3). The prevalence of RE in preparatory and secondary students was 44.5% and 43.2%, respectively. The proportion of myopia (≥ −0.5 D) and hyperopia (≥ +0.5 D) among students with RE was 82.2% and 17.8%, respectively. Family history of RE was positively associated to RE in students (odds ratio: 1.8 [95% CI: 1.3, 2.5]). The current screening initiative identified 45 (6.4%) new cases of RE who required spectacles. The compliance rate for using visual aid among students with RE was 74.6%. The prevalence of anisometropia and strabismus was 3.0% and 4.1%, respectively.CONCLUSIONS:A high proportion of Saudi adolescence in Riyadh have RE. Periodic ophthalmic assessment and refractive services are recommended as part of school health screening initiatives.

BackgroundTo investigate the prevalence and time trends of refractive error (RE) among Chinese children under 18 years old.MethodsPubMed, Embase, Web of Science were searched for articles that estimated prevalence of RE in Chinese children. Data of identified eligible studies was extracted by two investigators independently. Pooled prevalence of RE and its 95% confidence interval (95% CI) and the time trends of RE were investigated using Meta-analysis methods.ResultsOf the 41 studies covering 1 051 784 subjects, the pooled prevalence of myopia, high myopia, hyperopia and astigmatism in Chinese children was 38.0% (95% confidence interval (CI) = 35.1%-41.1%), 2.8% (95% CI = 2.3%-3.4%), 5.2% (95% CI = 3.1%-8.6%) and 16.5% (95% CI = 12.3%-21.8%), respectively. Subgroup analysis show that children living in urban were at higher risk of RE. Prevalence of myopia and hyperopia were higher in Northern China compared with Southern China and high myopia and astigmatism were higher in Hong Kong, Macau and Taiwan than in mainland China. Regression analysis showed an upward trend in myopia and hyperopia and a downward trend in high myopia and astigmatism with years.ConclusionsThe prevalence of RE is higher in urban areas than in rural for Chinese children. The much higher prevalence of myopia and astigmatism in China compared with foreign countries indicates the important role played by environment and genetic factors. Considering the large magnitude of refractive errors, much more attention should still be paid to RE prevention and treatment strategy development in China.

Amblyopia is reduction of vision with the proper optical correction either in one or both eyes.. The diagnosis of Amblyopia requires both the demonstration of visual acuity loss and the absence of an organic cause. A visual defect screening program was conducted on children aged 3-14 years of Bope-Poddala health unit area of the city of Galle Sri Lanka. Children aged 5-14 years were examined at each respective school. Children aged 3-5 years were examined at the pre schools .Children not attending to pre schools were examined in the community. All possitives and difficult to handle cases with a 10% of normal were referred to the ophthalmology clinic for secondary screening, investigation and diagnosis. Cases of diagnosed Amblyopia were called after one year for re-assessment. A total of 6685 school children and 934 preschool children were enrolled for this study. After exclusion, 5649 children were screened.Out of the total of 5649 children who were screened 439 (7.8%) were found to have eye diseases with or without visual defects giving a prevalence of 78/1000 children. Of those with such diseases, 88.8% had visual defects. The prevalence of visual defect was 6.9% (69/1000 children). Of the children with visual defects 90.0% (351) were due to refractive errors. The prevalence of refractive errors was 6.2% (62/1000 children).The analysis of the prevalence of different types of refractive errors showed that the prevalence of myopic astigmatism was 52.3%, Simple myopia was 24.6%, simple hypermetropia was 12.5%. Myopic astigmatism was the commonest type of refractive error in unilateral or bilateral involvement. The second commonest was simple myopia. It was found that out of 223 children with bilateral refractive errors 11.6% had unilateral Amblyopia and 17.5% had bilateral Amblyopia giving a total of 29.1%. Of all children with unilateral refractive errors 39.8% had Amblyopia. The development of Amblyopia among unilateral refractive errors was higher than bilateral refractive errors (p<0.05).The total prevalence of refractive Amblyopia was 2.1% of the population. Of them 1.4% had unilateral Amblyopia and 0.7% had bilateral Amblyopia. This difference was statistically significant. (P<0.05) Highest prevalence was observed in the age group of six and seven years (3.4% and 3.0%.). Distribution of Amblyopia among males and females were almost equal. The total prevalence of Amblyopia among children was 2.3%. Refractive Amblyopia calculated was 2.1% that consisted of 1.9% of Anisometropic Amblyopia.The strabismic Amblyopia was 0.2%. Deprivation Amblyopia was 0.2%. There were no Amblyopes found in the group of strabismic Amblyopia without refractive errors.

Clinical relevance Country-specific estimates of the prevalence of refractive errors are important to formulate national eye health policies for refractive care services. Background The purpose of this study was to systematically synthesise available literature and estimate the prevalence of refractive errors in the Nepalese population. Methods PubMed, Scopus, and Web of Science databases were systematically searched for articles on refractive errors and presbyopia published in English language until 27 September 2022. Population and school-based quantitative, cross-sectional prevalence studies and Rapid Assessment of Avoidable Blindness survey repository data were included. The quality of the included studies was assessed using the Newcastle Ottawa scale adapted for cross-sectional studies. Data extraction was performed with consensus among the reviewers. Meta-analysis of the prevalence was performed using the Random effects model to estimate the pooled proportions. Results A total of 38 studies with 101 701 participants were included: 18 studies in children (n = 31 596) and 20 in adults (n = 70 105). In children, the estimated pooled prevalence of overall refractive errors was 8.4% (95% CI: 4.8 to 12.9) with myopia, hypermetropia and astigmatism prevalent in 7.1% (95% CI: 3.7 to 11.4), 1.0% (95% CI: 0.7 to 1.3) and 2.2% (95% CI: 0.9 to 3.9), respectively. In adults, the prevalence of refractive errors, uncorrected refractive errors, and uncorrected presbyopia were 11.2% (95% CI: 8.0 to 14.9), 7.3% (95% CI: 5.4 to 9.5) and 78.9% (95% CI: 69.1 to 87.3), respectively. Conclusions The pooled prevalence of refractive errors is relatively low while uncorrected refractive errors and presbyopia are high in Nepalese population suggesting a need for better access to refractive care services in the country. The paucity of quality evidence on prevalence of refractive errors, particularly in children, indicates a need for a well-designed population-based study to accurately estimate the current prevalence of refractive errors.