Prevalence of Refractive Error and its Associated Factors among School Children in Chamarajanagar: A Cross-Sectional Study

Abstract

Background: Refractive errors are among the leading causes of preventable visual impairment in school-aged children and can adversely affect academic performance, psychosocial development, and quality of life. Early identification and timely correction through school-based vision screening programs are essential to reduce the burden of visual impairment and improve educational outcomes. This study aimed to estimate the prevalence of refractive errors, identify associated risk factors, and assess spectacle use among school children in Chamarajanagar district.

Methods: A school-based cross-sectional study was conducted over 18 months (April 2024–October 2025) among 275 students aged 12–14 years studying in selected government and private schools of Chamarajanagar district. Participants were selected using a multistage sampling technique. Sociodemographic characteristics, lifestyle factors, ocular symptoms, and parental history were collected using a pretested semi-structured questionnaire. Visual acuity was assessed using the Snellen chart, followed by objective refraction using retinoscopy. Data were analyzed using SPSS version 21, and associations were tested using chi-square and Fisher's exact tests, with a p-value <0.05 considered statistically significant.

Results: The prevalence of refractive error was 12.4%, with myopia (82.4%) being the most common type, followed by hypermetropia (11.7%) and astigmatism (5.9%). Among children with refractive errors, 61.7% were already using corrective spectacles. Refractive errors showed significant associations with socioeconomic status, parental history of refractive error, ocular symptoms (blurred vision, headache, watering, and redness), prolonged homework duration, television viewing, mobile/video gaming, computer use, and reduced outdoor activity. No significant association was observed with age, gender, school type, class, residential area, BMI, family type, continuous reading duration, or posture during reading and television viewing.

Conclusion: Refractive errors, particularly myopia, constitute a significant ocular health problem among school children in Chamarajanagar. Regular school vision screening, early diagnosis, health education, promotion of outdoor activities, reduction of excessive screen time, and timely spectacle correction are essential to prevent avoidable visual impairment and improve children's educational performance and quality of life. The findings provide valuable district-level evidence to strengthen school eye health programs and targeted preventive strategies.