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Prevalence and risk factors of refractive errors among preparatory school students in Beni-Suef, Egypt



Studying the epidemiology of refractive errors (REs) among school students is important for developing national strategies that can prevent visual impairment. The purpose of this study was to detect the prevalence and risk factors of RE among preparatory school students in Beni-Suef, Egypt.


In this cross-sectional study, a total of 469 school students aged 12~14 years received visual acuity (VA) assessments using Snellen’s chart, and students who failed the test (visual acuity worse than 6/9 in either eye) were subjected to refractive evaluation using an autorefractor.


The overall prevalence of RE among the sampled students was 22.8% (71% myope and 29% hyperope). There was a statistically significant association between RE and family factors. Students whose parents both wore glasses were more likely to have RE (P < 0.001, OR = 3.24) and students with two or more siblings wearing glasses showed higher rates of RE (P < 0.001, OR = 4.5). Students with RE reported more hours/day watching TV (P < 0.001, OR = 3.59).


The prevalence of RE in preparatory school students in Beni-Suef was detected. Family history and indoor activities are determining risk factors for RE. Nearly half of our school students with RE were newly detected in this study.

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  • Abou Elel MA, Adel R, Fahmy M (1992) Evaluation of screening methods for detection of refraction and visual acuity defect. Cairo. Department of Public Health, Faculty of Medicine, Cairo University, MSc thesis

  • Carter MJ, Lansingh VC, Schacht G, Río del Amo M, Scalamogna M, France T (2013) Visual acuity and refraction by age for children of three different ethnic groups in Paraguay. Arq Bras Oftalmol 76(2):94–97

    Article  PubMed  Google Scholar 

  • Castanon Holguin AM, Congdon N, Patel N, Ratcliffe A, Esteso P, Toledo Flores S (2006) Factors associated with spectacle-wear compliance in school-aged Mexican children. Invest Ophthalmol Vis Sci 47:925–992

    Article  PubMed  Google Scholar 

  • Dandona R, Dandona L, Srinivas M, Sahare P, Narsaiah S, Muñoz SR (2002) Refractive error in children in a rural population in India. Invest Ophthalmol Vis Sci 43:615–622

    PubMed  Google Scholar 

  • El Sayed SH, Mohamed M, Ahmed S (1993) Study of ametropia in primary school children in Monifia. Bull Ophthalmol Soc Egypt 86:345–350

  • Fulk GW, Goss DA (2001) Relationship between refractive status and teacher evaluations of school achievement. J Opt Vis Dev 32(2):80–82

    Google Scholar 

  • Gomes-Neto J, Hanushek E, Leite R, Frota-Bezzera R (1997) Health and schooling: evidence and policy implications for developing countries. Econ Edu Rev 16(3):271–282

    Article  CAS  Google Scholar 

  • Hassanien RM, Hammouda LM, Abdalla AE (2001) Prevalence and Causes of visual acuity in school children in Alminya area. Bull Ophthalmol Soc Egypt 94(6):929–932

    Google Scholar 

  • Hawthorne FA, Young TL (2013) Genetic contributions to myopic refractive error: insights from human studies and supporting evidence from animal models a Center for Human Genetics. Exp Eye Res 114:141–149

    Article  CAS  PubMed  Google Scholar 

  • Holden BA, Sulaiman S, Knox K (2000) The challenge of providing spectacles in the developing world. Community Eye Health 13:9–10

    CAS  PubMed  PubMed Central  Google Scholar 

  • Ip JM, Rose KA, Morgan IG, Burlutsky G, Mitchell P (2008) Myopia and the urban environment: findings in a sample of 12-year-old Australian school children. Invest Ophthalmol Vis Sci 49(9):38–58

    Article  Google Scholar 

  • Luo HD, Gazzard G, Liang Y, Shankar A, Tan DT, Saw SM (2006) Defining myopia using refractive error and uncorrected logMAR visual acuity >0.3 from 1334 Singapore school children ages 7–9 years. Br J Ophthalmol 90(3):362–366

    Article  PubMed  PubMed Central  Google Scholar 

  • Maul E, Barroso S, Munoz SR, Sperduto R, Ellwein LB (2000) Refractive error study in children: results from La Florida. Chile Am J Ophthalmol 29:445–454

    Article  Google Scholar 

  • Mavracanas TA, Mandalos A, Peios D, Golias V, Megalou K, Gregoriadou A (2000) Prevalence of myopia in a sample of Greek students. Acta Ophthalmol Scand 78(6):656–659

    Article  Google Scholar 

  • Murthy GV, Gupta SK, Ellwein LB, Muñoz SR, Pokharel GP, Sanga L (2002) Refractive error in children in an urban population in New Delhi. Invest Ophthalmol Vis Sci 43:623–631

    CAS  PubMed  Google Scholar 

  • Mutti DO, Mitchell GL, Moeschberger ML (2002) Parental myopia, near work, school achievement, and children’s refractive error. Invest Ophthalmol Vis Sci 43:3633–3640

    PubMed  Google Scholar 

  • Naidoo KS, Raghunandan A, Mashige KP, Govender P, Holden BA, Pokharel GP (2003) Refractive error and visual impairment in African children in South Africa. Invest Ophthalmol Vis Sci 44:3764–3770

    Article  PubMed  Google Scholar 

  • Negrel AD, Maul E, Pokharel GP, Zhao J, Ellewein LB (2000) Refractive error study in children: sampling and measurement methods for a multi-country survey. Am J Ophthalmol 129:421–426

    Article  CAS  PubMed  Google Scholar 

  • Norlaila MD, Mohd Ali B, Mohammed Z, Bashirah I, Sharanjeet K, MohidinN (2002) Prevalens kesalahan refraktif satu sampel populasi orang asli di Malaysia. Jurnal Kesihatan Masyarakat 8:43–45

  • Ovenseri-Ogbomo GO, Omuemu VO (2010) Prevalence of refractive error among school children in the cape coast municipality. Clin Optom 117(6):1278–1279

    Google Scholar 

  • Pascolini D, Mariotti SP (2012) Global estimates of visual impairment in 2010. Br J Ophthalmol 96:614–618

    Article  PubMed  Google Scholar 

  • Pokharel GP, Negrel AD, Munoz SR, Ellwein LB (2000) Refractive error study in children: results from Mechi zone. Nepal Am J Ophthalmol 129:436–644

    Article  CAS  PubMed  Google Scholar 

  • Resnikoff S, Pascolini D, Mariottia SP, Pokharel GP (2008) Global magnitude of visual impairment caused by uncorrected refractive errors in 2004. Bull World Health Organ 86:63–70

    Article  PubMed  PubMed Central  Google Scholar 

  • Saad A, El-Bayoumy BM (2007) Environmental risk factors for refractive error among Egyptian schoolchildren. East Mediterr Health J 13(4):819–828

    CAS  PubMed  Google Scholar 

  • Salomao SR, Cinoto RW, Berezovsky A, Mendieta L, Nakanami CR, Lipener C (2008) Prevalence and causes of visual impairment in low-middle income school children in Sao Paulo, Brazil. Invest Ophthalmol Vis Sci 49(10):4308–4313

    Article  PubMed  Google Scholar 

  • Yared AW, Belaynew WT, Destaye S, Ayanaw T, Zelalem E (2012) Prevalence of refractive errors among school children in Gondar town, Northwest Ethiopia Middle East. Afr J Ophthalmol 19(4):372–376

    Google Scholar 

  • Zhao J, Pan X, Sui R, Munor SR, Spertudo RD, Ellwein LB (2000) Refractive error study in children: results from Shunyi District, China. Am J Ophthalmol 129:427–435

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Ahmed Emad El-Din Arafa.

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The study was conducted in full accordance with the guidelines for Good Clinical Practice and the Declaration of Helsinki. The protocol was approved by the Research Ethics Committee at the Faculty of Medicine, Beni-Suef University. The heads of the selected schools were briefed on the purpose of the study and signed an informed consent form on behalf of the school children. Verbal assent of the students was sought before they were examined.

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The authors declare no conflict of interests.

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Arafa, A.E.ED., Ewis, A.A.E., Mahran, W.M. et al. Prevalence and risk factors of refractive errors among preparatory school students in Beni-Suef, Egypt. J Public Health (Berl.) 27, 43–47 (2019).

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  • Refractive errors
  • School students
  • Risk factors
  • Prevalence