Refractive errors among Saudi college students and associated risk factors

Bayan A Alsaif,1 Mohanna Y Aljindan,2 Hanan M Alrammah,1 Malak O Almulla,1 Saad S Alshahrani3 1College of Medicine, King Fahad Hospital of the University, Imam Abdulrahamn Bin Fasial University, Khobar, Saudi Arabia; 2Department of Ophthalmology, King Fahad Hospital of the University, Imam Abdulrahman Bin Fasial University, Khobar, Saudi Arabia; 3Epidemiology Department, King Fahd Specialist Hospital, Dammam, Saudi Arabia 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. Keywords: near-work, outdoor activity, college students, axial length, keratometry, anterior chamber depth, myopia, biometr