Prevalence Refractive Errors among Medical Students of Qassim University, Saudi Arabia: Cross-Sectional Descriptive Study

The Clinical Characteristics of Amblyopia in Children Under 17 Years of Age in Qassim Region, Saudi Arabia

Purpose

To provide the clinical characteristics of amblyopia in children under 17 years of age in Qassim Region, Saudi Arabia.

Patients and Methods

The study was a cross-sectional hospital-based, included 121 children with amblyopia aged between 3 and 17 years, referred from 6 hospitals in Qassim region to the paediatric optometry clinic at Qassim University medical city. Demographics and comprehensive ocular examination including visual acuity (VA), assessment of anterior and posterior segment, cycloplegic refraction (RE), angle of deviation, and cause of amblyopia were collected.

Results

The mean age at diagnosis of amblyopia was 8.93 ± 3.67 years. The leading cause of amblyopia was strabismus and anisometropia shared the same percentage at 29.75%, and the combined-mechanism at 18.18%. Amblyopia was more common in males 57.85%, particularly strabismic amblyopia in 66.67% and anisometropic amblyopia in 61.11%, p = 0.408. Amblyopia was more predominant in the age group 6- to 9-year-old, particularly, strabismic amblyopia 44.44%, and amblyopia due to a combined mechanism of 36.36%, p = 0.066. The degree of hyperopia was not varied by the cause of amblyopia (P = 0.401), with slightly high hyperopia found in ametropic and strabismic amblyopia. Conversely, hyperopic astigmatism was significantly associated with amblyopia P = 0.020, with a high degree of hyperopic astigmatism found in meridional amblyopia and ametropic amblyopia.

Conclusion

The commonest types of amblyopia in children were attributed to strabismus and anisometropia. Causes of amblyopia differed by age group with strabismus, anisometropia, and combined mechanism accounting for most children aged 6- to 9-years and strabismus for children aged less than 6 years. Hyperopic and myopic astigmatism were significantly associated with anisometropia and meridional amblyopia. Therefore, efforts should be made for early diagnosis and management of childhood amblyopia and uncorrected refractive errors to avoid their impact on quality of life.

Validation of the Arabic version of the quality of life impact of refractive correction questionnaire

PURPOSE

To validate the Arabic version of the quality of life impact of refractive correction (QIRC) questionnaire.

METHODS

This was a cross-sectional study included participants with refractive errors (myopia, hypermetropia, or astigmatism) aged between 19 and 40 years who were pre or postrefractive surgeries. Uncorrected distance visual acuity, refraction, and corneal topography were collected. The 20-item QIRC questionnaire was translated to the Arabic language and then back translated to the English language. Participants were asked to answer all items of the Arabic QIRC. The validity and reliability of the translated questionnaire were tested using Rasch analysis.

RESULTS

A total of 145 participants with refractive errors participated in this study. The mean age ± standard deviation of participants was 26.29 ± 5.1 years. Person separation (2.01) and reliability (0.80) indicates good precision and stability of the Arabic QIRC questionnaire. Item infit was ranged between 0.82 and 1.23; and item outfit was range between 0.76 and 1.32. The items were well targeted to the persons with a mean difference of 0.30. Skew and kurtosis values were within the normal limits (-2.00 to + 2.00). Cronbach's α for the scale was 0.79, which indicates good reliability of the Arabic 20-item QIRC.

CONCLUSION

The Arabic 20-item QIRC questionnaire is a valid tool to assess the impact of refractive correction on Arabian participants' quality of life.

Myopia: An Increasing Problem for Medical Students at the University of Gondar

Purpose

The purpose of this study was to assess the prevalence and associated factors of myopia among medical students at the University of Gondar College of Medicine and Health Sciences, Northwest Ethiopia.

Patients and Methods

Institution-based cross-sectional study was conducted at the University of Gondar College of Medicine and Health Sciences from June 20 to August 15, 2021. A simple random sampling technique with proportional allocation was used to select 492 students. Interviewer-administered questionnaire, Snellen acuity chart, pinhole, retinoscope and direct ophthalmoscope were used to collect the data. The data were entered to EpiData version 4.6 and exported to SPSS version 25 for analysis. Descriptive statistics were summarized by measures of central tendency. Variables with p-value ≤0.2 in bivariable regression were entered into a multivariable logistic regression model. Adjusted odds ratio with 95% confidence interval was used and variables with p-values <0.05 were considered as statistically significant.

Results

A total of 492 respondents participated giving a response rate of 98.3%. The prevalence of myopia was found to be 16.7% (95% CI = 12.8–19.4%). Urban residents (AOR = 1.56; 95% CI: 1.28–6.21), family history of myopia (AOR = 2.31; 95% CI: 1.33–4.54), near-work activity of 5–7 hours (AOR = 2.41; 95% CI: 1.31–5.76) and ≥8 hours (AOR = 4.35; 95% CI: 1.96–9.66), outdoor activity for <3 hours (AOR = 1.65 95% CI: (1.14–4.53), were significantly associated with myopia.

Conclusion

The prevalence of myopia among medical students at the University of Gondar College of Medicine and Health Sciences was high. Urban residency, positive family history, longer time spent on near-work activities and less outdoor activity were positively associated with myopia.

Barriers and Perception Towards Spectacle Wear among a Student Population of University of Buraimi, Oman

Objectives

The study aimed to evaluate the barriers and perceptions towards spectacle wear among the student population of the University of Buraimi, Oman.

Methods

A descriptive, questionnaire-based and cross-sectional study was conducted between December 2017 and May 2018. Ophthalmic examination and a standard spectacle prescription protocol were used to identify those with inappropriate spectacle coverage. A self-designed and expert validated English-language questionnaire was utilised. A chi-square test was used to assess the association between the participants’ types of perceptions and sociodemographic and refractive error-related profiles.

Results

In total, 275 students participated in the study (response rate: 17.19%) and 170 (61.8%) were having inappropriate spectacle correction. Only 26% of them used spectacles since the majority (73.5%) had never had their eyes examined before this study. Most perceived spectacle wear positively (53.5%), followed by some having negative (36.5%) or neutral (10.0%) perceptions. Those from a health science background including Nursing and Optometry had a higher positive perception towards spectacle wear than others (P = 0.012). The difference in the perception scores between myopic and hypermetropic refractive error groups was statistically insignificant (P = 0.882).

Conclusion

The majority of the participants had had inappropriate vision corrections with spectacles and not undergone any prior ocular examinations. Few wore spectacles; however, these were inappropriate given their current refractive status. The reasons for spectacle non-wear were that either new spectacles had been ordered or spectacles were lost or broken. It is recommended that the school eye health initiative be extended to the university level. A holistic eye-health promotional approach toward integrating students, teachers and parents into this initiative can improve spectacle wear within the studied population.

Visual Function of Drivers and its Relation to the Occurrence of Road Traffic Accidents in Saudi Arabia

BACKGROUND: The mortality rate due to road traffic accidents (RTA) is significantly high in Saudi Arabia (SA) compared to other countries. The visual function which includes good visual acuity (VA) and binocular vision are very important factors that can contribute to the incidence of RTA. AIM: The aim of this study is to investigate the association between refractive errors (REs) and the RTA in SA. METHODS: A total of 354 participants (mean age 22.67 ± 3.22 years) were recruited randomly to participate in this study from the population of Qassim district. Data collected using the questionnaire included participants’ age, sex, and education level, ocular and medical history, driving history as well as history of RTA. Ocular health examination including VA, RE measurements, and binocular vision function vision was measured and analyzed. RESULTS: The results of this study show that 48.3% of drivers had some form of REs with 3.4% being visually impaired. 217 (61.3%) of participants have had an RTA, and 119 (54.9%) of them have had more than two accidents in the past two years. The findings show no significant association between the occurrence of RTA and uncorrected REs or binocular vision dysfunction. CONCLUSION: Our data showed significantly higher rate of RTA among Saudi drivers which is much higher than any country in the world. The current Saudi regulations for obtaining driving license need to be modified, with implementing a comprehensive eye examination prior to acquiring or renewing drivers’ licenses.

Visual status among undergraduate students: Findings from an emerging university in Saudi Arabia

BACKGROUND

Refractive error is an important preventable cause of visual impairment and blindness worldwide. In adult life, reduced vision can potentially affect the academic performance, choice of occupation and socio-economic status. This study aimed to assess the prevalence of refractive errors and related visual impairment among undergraduate male students in Prince Sattam bin Abdulaziz University in Al-Kharj, Saudi Arabia.

METHODS

A descriptive cross-sectional study was employed in the current work. After obtaining an informed consent; each eligible student was asked to fill a self-constructed survey and have screened in the college premises for visual acuity and refractive error. Candidates detected with defective vision have been referred for further examination at well-equipped ophthalmology clinic in the University Hospital.

RESULTS

A total of 420 undergraduate students, with age ranged from 18 to 30 years, have participated in the current study. About 25.0% of the participants have used spectacles at the time of examination. Positive family history of spectacles use was found in 71.4%. Our study showed that visual acuity in the better eye was low in 34.76% of the participants. Seventy-eight students (18.6%) of the total participants reported defective vision and have fulfilled refractometric examination. Of the examined students 83.3% were found to have refractive errors. Astigmatism, 52.6%, was the most frequently encountered refractive error among the participants; followed by myopia, 26.9%; and hypermetropia 2.6%.

CONCLUSION

The current study confirms that refractive error is an important preventable cause of visual impairment. Significant portion of the examined participants were found to have refractive errors recommending further work to improve visual status in undergraduate students.

The prevalence of refractive errors among Saudi adults in Riyadh, Saudi Arabia

PURPOSE:

To determine the prevalence of refractive errors among Saudi adults in Riyadh, Saudi Arabia.

METHODS:

A cross-sectional study was conducted targeting healthy Saudi adults (20–40 years old) at two major gatherings in Riyadh, Saudi Arabia from December 2018 to January 2019. Refractive errors were measured, and data pertaining to age, sex, region of origin, and spectacle use was collected. Clinically significant myopia was defined as SE ≥ -0.50 D, hyperopia as SE ≥ 0.50D, and astigmatism as cylindrical error ≥ 0.50D. Refractive error measurements were assessed using Topcon's Auto-Kerato-Refractometer, KR-800.

RESULTS:

A total of 660 adult individuals (1,319 eyes) were included in this study, of which 321 participants (48.7%) were found to be myopes, 167 subjects (25.2%) were hyperopes, and 438 individuals (66.3%) had astigmatism. With regards to correlations, myopia was highly correlated with being male (P-value = 0.036), belonging to age group 20–25 years (P-value = 0.033), originating from the northern regions of Saudi Arabia (P-value <0.001). Similarly, hyperopia was significantly correlated with being male (P-value = 0.048), age groups 20–25 years (P-value = 0.04), and 31–35 years (P-value = 0.011) and was higher in people from northern region (P-value = 0.011). In contrast, astigmatism was only found to be correlated with age group 36–40 years (P-value = 0.002). Additionally, 71.7% of myopic participants and 76.1% of astigmatic individuals opted not to wear spectacles (P-value <0.001).

CONCLUSION:

In this study, the refractive error with the highest prevalence among Saudis was astigmatism, followed by myopia and hyperopia. Gender, region of origin, and spectacle wear were all observed to be highly correlated with higher rates of refractive error.

Prevalence of Refractive Errors and its Associated Risk Factors among Medical Students of Jazan University, Saudi Arabia: A Cross-sectional Study

PURPOSE

Refractive errors (REs) are common and continue to increase globally, particularly myopia. Uncorrected REs are the second leading cause of preventable blindness and the most common cause of visual impairment. The main objective of this study is to assess the prevalence of REs and to investigate its associated risk factors among medical students of the Jazan region, Saudi Arabia.

METHODS

An observational analytical cross-sectional study was conducted among a random sample of 447 medical students at Jazan University. Eye examination was conducted using an autorefractor test (Huvitz HRK-8000A Autorefractor Keratometer) to measure spherical refraction (emmetropia, myopia, and hyperopia) and cylindrical refraction (astigmatism). Factors associated with myopia and hyperopia were evaluated using logistic regression models.

RESULTS

The overall prevalence of REs was 48.8% (95% confidence interval [CI] [44.2, 53.4]). The prevalence of REs among female medical students was 55.1% (95% CI [48.6, 61.5]), which was significantly higher than that among males (42.3%, 95% CI [36.0, 48.9]), with a P = 0.007. Of the 447 medical students examined, approximately one-third (33.8%) had myopia, 10.5% had astigmatism, and only 10.5% had hyperopia. The results of logistic regression indicated that females were 52% more myopic than males (odds ratios [OR] = 1.52, 95% CI [1.04, 2.22]), while participants with both parents having a history of REs were twofold more myopic than students with no family history of REs (OR = 2.01, 95% CI [1.2, 3.4]). A history of blurred vision also increases the risk of myopia by seven times (OR = 7.2, 95% CI [6.4, 11.3]).

CONCLUSION

RE among medical students is a problem. Thus, it needs to be assessed carefully before students choose a specialty that may need very good near and far vision for postgraduate study.

The prevalence of refractive errors in the Middle East: a systematic review and meta-analysis

PURPOSE

The purpose of the present study was to evaluate the prevalence of refractive errors in the Middle East region.

METHODS

In this meta-analysis, a structured strategy was applied to search databases PubMed, Web of Science, Scopus, and Google Scholar, databases as well as the reference lists of the selected articles to identify cross-sectional studies assessing the prevalence of refractive errors in the Middle East region until September 2019. The outcome measure was the prevalence of refractive errors, including myopia, hyperopia, and astigmatism, in two age groups of ≤ 15 years and > 15 years. The study results were combined using a random effects model at a confidence level of 95%.

RESULTS

The prevalence of myopia, hyperopia, and astigmatism was 4% (95% CI 4, 5), 8% (95% CI 6, 10), and 15% (95% CI 10, 19) in people less than or equal to 15 years and 30% (95% CI 25, 34), 21% (95% CI 15, 28), and 24% (95% CI 16, 31) in subjects over 15 years, respectively. The prevalence of myopia, hyperopia, and astigmatism was 3.5%, 12.4%, and 9.0% in male and 4.2%, 13.1%, and 9.9% in female subjects aged ≤ 15 years, respectively. In subjects aged > 15 years, the prevalence was 31.7%, 14.5%, and 31.5% in males and 31.9%, 11.2%, and 31% in females, respectively.

CONCLUSION

The prevalence of hyperopia is relatively high in Middle Eastern children, while the prevalence of myopia is higher in adults in this region. It seems that astigmatism is not a serious refractive problem in this region compared to the rest of the world.

Accuracy, speed and repeatability of the voice assisted subjective refractor (VASR)

PURPOSE

To compare the accuracy, speed and repeatability of the voice assisted subjective refractor (VASR) to traditional refractive methods.

METHODS

Fifty healthy adult subjects were examined by autorefractor, followed by subjective phoropter refinement. Subjects were then evaluated using the VASR (Vmax Vision) to obtain an objective and subjective result. Three total assessments were performed for each subject using each of the methods described. Corrected visual acuity was recorded for each eye after each procedure. The total time was measured for both the traditional and VASR refraction.

RESULTS

A comparison of the results obtained by traditional refraction and VASR revealed no statistically significant difference from the mean in equivalent sphere measurements (P=0.1383), and the datasets were highly correlated (r=0.993). The data comparisons for cylinder power and axis were similar (cylinder: P=0.6377, r=0.864) (axis: P=0.6991, r=0.738). VASR, on average, required 71 additional seconds to complete when compared to traditional phoropter refraction. In terms of repeatability, the average difference noted upon repeat of equivalent sphere power was 0.01 D for the phoropter (P=0.98) and 0.10 D for the VASR (P=0.23). For sphere power, the average difference was 0.02 D for the phoropter (P=0.55) and 0.07 D for the VASR (P=0.58). For cylinder power, the average difference was 0.02 D for the phoropter (P=0.11) and 0.03 D for the VASR (P=0.39). For all refractive methods, the differences between measurements amounted to ≤0.10 diopters, which is neither clinically nor statistically significant.

CONCLUSION

Refractive error results obtained with the VASR were not statistically different from those achieved using traditional phoropter methods. Time elapsed for the VASR was slightly longer than a more traditional refractive sequence. The VASR demonstrated clinically and statistically significant repeatability of measurement, consistent with traditional refraction.

Prevalence and pattern of refractive errors among Saudi adults

Background & Objectives:

Refractive Errors (RE) are responsible for major portion of the treatable visual impairment and avoidable blindness in the world. The prevalence of RE varies with age, gender, ethnicity, geographical locations and also from time to time due to progresse in eye care services. We aimed to study the prevalence of RE and assess their patterns among Saudi adults of Arar city, the capital of Northern Border Region of Saudi Arabia.

Methods:

This is a cross-sectional, population-based study. A total number of 966 Saudi adults aged 16 to 39 years were enrolled. The patterns of their RE were studied through auto-refraction evaluation.

Results:

The prevalence of RE was 45.8%. The most frequent type of RE was myopia in 24.4%, followed by hyperopia 11.9% and astigmatism in 9.5% cases. Ages and genders significantly affect the prevalence of the different patterns of RE (0.033 and 0.012, respectively).

Conclusion:

The prevalence of RE in Arar city is slightly lower than that previously published in the same targeted age group. Myopia is the main RE. More awareness programs, especially among young adults are recommended for better outcomes.

Refractive errors among Saudi college students and associated risk factors

Objectives

To determine the prevalence of refractive errors among freshman students of Imam Abdulrahman Bin Faisal University (IAU), and to examine the relationship of near-work activities and outdoor activities with refractive errors.

Methods

A cross-sectional study of 338 freshman students of IAU (162 males, 176 females) was carried out. Students were selected using a simple random sampling technique. Eye examination was done including non-cycloplegic autorefraction for determining the refractive error status. Myopia was defined as spherical equivalent refraction (SER) ≤−0.75 diopters (D), and it was further divided into low myopia (SER from −0.75 D to −2.99 D), moderate myopia (SER from −3.00 to −5.99 D), and high myopia (SER ≤−6.00 D). Hyperopia was defined as SER ≥1.00 D and emmetropia as having an SER value between that of low myopia and hyperopia. SER was calculated as sphere + 1/2 cylinder. A questionnaire detailed on activities was completed by participants.

Results

Myopia was found in 47.9% of the students (95% CI 42.7%–53.3%). The most prevalent type of myopia was low myopia (66.7%; 95% CI 59.1%–73.5%). Hyperopia and emmetropia were found in 6.5% (95% CI 4.3%–9.7%) and 45.6% (95% CI 40.3%–50.9%) of the students, respectively. Parental myopia was significantly associated with the myopic status of the students (P=0.007, Fisher’s exact test). About 6% of myopic students had a history of myopia in both parents. In addition, both parents had a history of myopia in 1.9% of emmetropic students, whereas such an association was absent in the hyperopic students. Refractive error type in both genders was not significantly predicted by the activity type.

Conclusion

Although the different types of activities did not predict the types of refractive errors, the high prevalence of myopia among the college students at this age requires further studies to explore more about the clinical characteristics and risk factors of the disease.