Background: Refractive error is one of the commonest causes of visual impairment among school-aged children all over the world, which can lead to poor academic performance and quality of?life when left untreated. The epidemiology of refractive error varies with geographical location; lifestyle and availability of eye care services vary, and there are?major differences between urban and rural areas.
Objective: This study aimed to estimate the prevalence, types and severity of refractive errors among 6-12 years old urban and rural primary school children in Tikrit city, Iraq, and?evaluate any associated ocular abnormalities.
Method: A cross-sectional observational study was carried out for 10?months between January,2025 to October,2025. A sample size of 400 primary school children was selected through stratified random sampling with equal allocation between urban and rural (200 students?in each category). Primary school screening was?succeeded by complete ophthalmologic examination at Tikrit Teaching Hospital and in private clinic. Examinations included visual acuity measurement, cycloplegic retinoscopy and auto refraction, slit-lamp evaluation, ocular?alignment testing, and fundus examination. Refractive?errors were categorized according to spherical equivalent.
Results: Refractive error was found in 148?children with an overall prevalence of 37.0%. Urban children showed a higher prevalence (45.0%) than their rural?counterparts (29.0%). The?most frequent refractive error in urban population was myopia (43.2%) followed by hypermetropia (31.1%), and astigmatism (25.7%). The prevalence of such lesions was slightly higher among females than males, but the difference was to be not statistically?significant. The refractive errors were predominantly mild to moderate in nature and no?posterior segment pathology was observed.
Conclusions: Refractive?errors are common among primary school students in Tikrit and they have more refractive errors in urban compared with rural children. The?most common refractive error was myopia. These results support the requirement for school-vision?screening programs and early treatment intervention in order to avoid potential avoidable visual impairment and increased academic underachievement.
International Journal of Medical Ophthalmology
