Background: Refractive errors are among the most common and preventable causes of visual impairment in children. Early detection and proper correction are essential to prevent long-term visual complications such as amblyopia and reduced academic performance. The present study aimed to determine the prevalence and distribution patterns of different types of refractive errors among elementary school boys in Hamedan Province, located in western Iran, where limited data are available on this age group.
Methods: This cross-sectional study was conducted between October 2022 and December 2023 on 1053 male students aged 6-12 years, selected through a multistage cluster sampling method covering both urban and rural areas. Examinations included Uncorrected visual acuity (UCVA), Best-corrected visual acuity (BCVA), cycloplegic refraction, cover test, and ophthalmoscopy, all performed by a trained optometrist following a standardized protocol. Based on cycloplegic spherical equivalent refraction, myopia was defined as -0.50 diopter or worse, hyperopia as +2.00 diopter or more, and astigmatism as a cylinder of -0.50 diopter or more. The data were statistically analyzed to explore the association between age and the type of refractive error.
Results: Data from 1027 students were included in the final analysis. The mean age of participants was 9.52±1.63 years. UCVA of 20/40 or worse was found in 16.5% of students, and BCVA of 20/40 or worse in 1.2%. The prevalence rates of myopia, hyperopia, and astigmatism were 6.5%, 5.6%, and 18.9%, respectively. With-the-rule astigmatism was the most frequent type observed. The prevalence of myopia tended to increase with age, while hyperopia showed a decreasing trend.
Conclusion: The findings revealed a relatively high prevalence of refractive errors, particularly astigmatism, among school-aged boys in western Iran. These results emphasize the importance of implementing periodic, school-based vision screening programs and ensuring better access to refractive care services. Promoting awareness among parents, teachers, and health authorities regarding the need for early eye examinations could play a crucial role in preventing avoidable visual impairment and improving children’s visual health and academic success.
