Prevalence and determinants of refractive error among school children in two Southern districts of Karnataka

Authors

  • Krishnamurthy K. V. Department of Community Medicine, JSS Medical College, JSSAHER, Mysuru, Karnataka, India
  • Sunil Kumar D. Department of Community Medicine, JSS Medical College, JSSAHER, Mysuru, Karnataka, India
  • Soumya H. V. Department of Ophthalmology, JSS Medical College, JSSAHER, Mysuru, Karnataka, India
  • Vanishri Arun Department of Information Science and Engineering, JSS Science and Technology University, Mysuru, Karnataka, India
  • Rakshitha J. Department of Community Medicine, JSS Medical College, JSSAHER, Mysuru, Karnataka, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20260009

Keywords:

Refractive error, Schoolchildren, Visual impairment, Screen hours

Abstract

Background: Refractive error (RE) is a major cause of visual impairment in schoolchildren, affecting learning and long-term eye health. Its prevalence varies across India, with limited data from southern Karnataka. This study assessed RE prevalence and determinants among children aged 6-16 years.

Methods: A school-based cross-sectional study was conducted from July to October 2025 among 1,070 students selected through cluster sampling using probability proportionate to size (PPS). Within each school, participants were chosen by simple random sampling. Data were collected using a structured proforma capturing sociodemographic, familial, clinical, and behavioural factors. Visual acuity was assessed using a standardized Snellen chart protocol. Statistical analysis included descriptive measures and Chi-square tests to determine associations between RE and selected variables.

Results: The prevalence of RE was 8.2%. Age and educational grade showed significant associations (p=0.005), with older children presenting higher impairment. Significant determinants included history of eye infection (p=0.027), family history of glasses (p=0.024), and screen exposure (p=0.014), with RE rising from 6.2% in low screen-time groups to 16.7% in high-exposure groups. Gender, parental education, family type, and history of eye injury were not significantly associated.

Conclusions: RE remains a notable concern among schoolchildren in southern Karnataka. Findings highlight the role of biological and behavioural determinants, underscoring the importance of strengthened school-based screening and early preventive interventions.

 

Metrics

Metrics Loading ...

References

Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br J Ophthalmol. 2012;96(5):614-8. DOI: https://doi.org/10.1136/bjophthalmol-2011-300539

Naidoo KS, Avesh R, Khathutshelo PM, Pirindhavellie G, Brien AH, Gopal PP, et al. Refractive error and visual impairment in children. Lancet. 2003;44(9):3764-70. DOI: https://doi.org/10.1167/iovs.03-0283

World Health Organization. Blindness and vision impairment: Refractive errors. Geneva: WHO. 2021. Available at: https://www.who.int/news-room/questions-and-answers/item/blindness-and-vision-impairment-refractive-errors. Accessed on 15 November 2025.

Holden BA, Timothy RF, David AW, Monica J, Kovin SN, Padmaja S, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 to 2050. Ophthalmology. 2016;123(5):1036-42. DOI: https://doi.org/10.1016/j.ophtha.2016.01.006

Saxena R, Vashist P, Tandon R. Prevalence of refractive errors and spectacle coverage among school children in North India. Indian J Ophthalmol. 2015;63(6):497-503.

Padhye AS, Sonam CB, Gupta N, Shenga DO. Prevalence of refractive errors among school children in India: A multicentric study. Indian J Ophthalmol. 2021;69(8):2154-60.

Dandona R, Dandona L. Refractive error blindness. Bull World Health Organ. 2001;79(3):237-43.

He M, Chua SYL, Seang-Mei S. Risk factors for myopia in children: A review of epidemiologic evidence. Clin Exp Optom. 2015;98(6):497-506. DOI: https://doi.org/10.1111/cxo.12346

Maul E, Barroso S, Munoz SR, Sperduto RD, Ellwein LB. Refractive error study in children: Results from South America. Am J Ophthalmol. 2000;129(4):445-54.

American Academy of Ophthalmology. Pediatric Eye Evaluations PPP. Ophthalmology. 2017;124(1):P1-9. DOI: https://doi.org/10.1016/j.ophtha.2016.09.027

Jones LA, Loraine TS, Donald OM, Gladys LM, Melvin LM, Karla Z. Parental history of myopia, sports and outdoor activities, and future myopia. Invest Ophthalmol Vis Sci. 2007;48(8):3524-32. DOI: https://doi.org/10.1167/iovs.06-1118

Gupta M, Gupta BP, Chauhan A, Bhardwaj A. Ocular morbidity among school children in Shimla, India. Indian J Ophthalmol. 2009;57(2):133-8.

Enthoven CA, Seang-Mei S. The association between screen time and myopia: A systematic review. Ophthalmic Physiol Opt. 2020;40(2):216-29. DOI: https://doi.org/10.1111/opo.12657

Sharma A, Congdon N, Patel M, Gilbert C. School-based vision screening programme-Evidence and recommendations for implementation. BMJ Glob Health. 2021;57(3):272-83. DOI: https://doi.org/10.1016/j.survophthal.2011.11.002

Padhye AS, Dole K, Gogate P. Prevalence of refractive errors among school children in Maharashtra. Indian J Ophthalmol. 2021;69(8):2154-60.

Maul E, Barroso S, Munoz SR, Sperduto RD, Ellwein LB. Refractive error study in children (RESC): Results from South America. Am J Ophthalmol. 2000;129(4):445-54. DOI: https://doi.org/10.1016/S0002-9394(99)00454-7

Saxena R, Vashist P, Tandon R, Pandey RM, Bhardawaj A, Menon V. Prevalence of refractive errors among school children in North India. PLoS ONE. 2015;10(2):e0117349. DOI: https://doi.org/10.1371/journal.pone.0117349

Bhutia KL, Bhutia SC, Gupta N, Shenga DO. Prevalence of refractive errors among school-going children in East Sikkim. Indian J Ophthalmol. 2021;69(8):2018-20. DOI: https://doi.org/10.4103/ijo.IJO_112_21

He M, Wenyong H, Zheng Y, Huang L, Ellwein LB. Refractive error and vision impairment in school children in rural China. Ophthalmology. 2007;114(2):374-82. DOI: https://doi.org/10.1016/j.ophtha.2006.08.020

Gupta M, Gupta BP, Chauhan A, Bhardwaj A. Ocular morbidity and refractive errors among school children in Shimla. Indian J Ophthalmol. 2009;57(2):133-8. DOI: https://doi.org/10.4103/0301-4738.45503

Murthy S, Gupta SK, Ellwein LB, MuñozSR, Pokharel GP, Sanga L, et al. Refractive Error in Children in an Urban Population in New Delhi. Invest Ophthalmol Vis Sci. 2002;43(3):623–31.

Joseph E, Ck M, Kumar R, Sebastian M, Suttle CM, Congdon N, et al. Prevalence of refractive errors among school-going children in a multistate study in India. Br J Ophthalmol. 2023;108(1):143-151. DOI: https://doi.org/10.1136/bjo-2022-322123

Srivastava T, Kumar A, Shukla E, Singh V, Anuranjani L. Prevalence of refractive error among school-going children in urban and rural settings. Cureus. 2024;16(4):e59197. DOI: https://doi.org/10.7759/cureus.59197

Hassan S, Sahila N, Zahoor N, Khan S, Makayee AA, Wahab A. Prevalence and pattern of refractive errors among school-age children. Indian J Ophthalmol. 2023;71(12):3642-5. DOI: https://doi.org/10.4103/IJO.IJO_982_23

Downloads

Published

2026-01-09

How to Cite

K. V., K., D., S. K., H. V., S., Arun, V., & J., R. (2026). Prevalence and determinants of refractive error among school children in two Southern districts of Karnataka. International Journal Of Community Medicine And Public Health, 13(2), 701–705. https://doi.org/10.18203/2394-6040.ijcmph20260009

Issue

Section

Original Research Articles