Prevalence of Refractive Errors Among School-Age Children and Adolescents in Saudi Arabia: A Systematic Review and Meta-Analysis
Abdulmajeed Al Khathami,1,* Mohamed Baklola,2,* Anwar Ali Alshehri,3 Lujain Hussain Alnasser,4 Razan Saleh Alshehri,5 Mohammed A Salawi,6 Rahaf Hussain Alwadai,7 Mohammed Al Ghazwi,8 Amira Ahmed Qadim Alanazi,9 Asayel Mojidea Alshammari,10 Naji Al-bawah,11,* Mayas...
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Dove Medical Press
2025-07-01
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| Series: | Clinical Ophthalmology |
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| author | Al Khathami A Baklola M Alshehri AA Alnasser LH Alshehri RS Salawi MA Alwadai RH Al Ghazwi M Alanazi AAQ Alshammari AM Al-bawah N Hafez M Abu Melha A |
| author_facet | Al Khathami A Baklola M Alshehri AA Alnasser LH Alshehri RS Salawi MA Alwadai RH Al Ghazwi M Alanazi AAQ Alshammari AM Al-bawah N Hafez M Abu Melha A |
| author_sort | Al Khathami A |
| collection | DOAJ |
| description | Abdulmajeed Al Khathami,1,&ast; Mohamed Baklola,2,&ast; Anwar Ali Alshehri,3 Lujain Hussain Alnasser,4 Razan Saleh Alshehri,5 Mohammed A Salawi,6 Rahaf Hussain Alwadai,7 Mohammed Al Ghazwi,8 Amira Ahmed Qadim Alanazi,9 Asayel Mojidea Alshammari,10 Naji Al-bawah,11,&ast; Mayas Hafez,12 Abdullah Abu Melha1 1Department of Ophthalmology, King Fahad Hospital, Al Baha Health Cluster, Al Baha, Saudi Arabia; 2Faculty of Medicine, Mansour University, Mansoura, Egypt; 3College of Medicine, University of Bisha, Bisha, Saudi Arabia; 4College of Medicine, University of Hail, Hail, Saudi Arabia; 5Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam, Saudi Arabia; 6College of Medicine, Taif University, Taif, Saudi Arabia; 7College of Medicine, Najran University, Najran, Saudi Arabia; 8Batterjee Medicine college, Jeddah, Saudi Arabia; 9College of Medicine, Northern Border University, Arar, Saudi Arabia; 10College of Medicine, Aljouf University, Aljouf, Saudi Arabia; 11Faculty of Medicine, Sana’a University, Sana’a, Yemen; 12Qatif Central Hospital, Al Qatif, 32654, Saudi Arabia&ast;These authors contributed equally to this workCorrespondence: Naji Al-bawah, Email Najialbawah@gmail.com Mohamed Baklola, Email Mohamedbaklola2000@gmail.comBackground: Refractive errors, including myopia, hyperopia, and astigmatism, are a leading cause of visual impairment among children worldwide. In Saudi Arabia, the prevalence of these conditions among school-age children and adolescents remains poorly understood, with significant variations reported across studies. This systematic review and meta-analysis aimed to provide a comprehensive estimate of the pooled prevalence of refractive errors in this population and explored factors influencing their distribution.Methods: A systematic search of PubMed, Scopus, Web of Science, and ScienceDirect was conducted in accordance with PRISMA 2020 guidelines. Observational studies reporting the prevalence of refractive errors among Saudi school-aged children and adolescents were included. Data extraction and quality assessment were conducted using the Newcastle-Ottawa Scale. Pooled prevalence estimates with 95% confidence intervals (CIs) were calculated using a random-effects model, and heterogeneity was assessed with the I² statistic.Results: Nine studies including over 15,000 participants were analyzed. The pooled prevalence of myopia was 6.7% (95% CI: 3.0% to 14.2%), hyperopia was 3.6% (95% CI: 1.3% to 9.8%), and astigmatism was 7.7% (95% CI: 2.5% to 20.9%). Subgroup analysis revealed regional disparities, with the highest myopia prevalence reported in Taif (33.3%) and Bisha (22.5%), and the lowest in Medina (1.6%). Studies conducted after 2018 showed a significantly higher pooled myopia prevalence (16.4%, 95% CI: 8% to 30.5%) compared to those published before 2018 (3.3%, 95% CI: 1.4% to 7.5%) (p < 0.001). While studies using cycloplegic refraction reported a slightly higher myopia prevalence (7.2%, 95% CI: 4.7% to 11%) than those using non-cycloplegic methods (6.7%, 95% CI: 2.4% to 17.5%), the difference was not statistically significant (p = 0.9). No significant difference was observed between studies with smaller or larger sample sizes, although high heterogeneity persisted across all subgroups.Conclusion: Refractive errors, particularly astigmatism, represent a significant and growing public health issue among Saudi school-aged children and adolescents. The findings underscore the urgent need for standardized diagnostic protocols, including the use of cycloplegic refraction, and the implementation of school-based vision screening programs.Keywords: myopia, hyperopia, astigmatism, refractive errors, children |
| format | Article |
| id | doaj-art-a39981d7c1934c1186d6ccbbf66ce2a0 |
| institution | Kabale University |
| issn | 1177-5483 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Ophthalmology |
| spelling | doaj-art-a39981d7c1934c1186d6ccbbf66ce2a02025-08-20T03:30:23ZengDove Medical PressClinical Ophthalmology1177-54832025-07-01Volume 19Issue 121172132104518Prevalence of Refractive Errors Among School-Age Children and Adolescents in Saudi Arabia: A Systematic Review and Meta-AnalysisAl Khathami A0Baklola M1Alshehri AA2Alnasser LHAlshehri RS3Salawi MA4Alwadai RHAl Ghazwi MAlanazi AAQ5Alshammari AMAl-bawah N6Hafez M7Abu Melha ADepartment of OphthalmologyPublic healthOphthalmologyCollage of medicineDepartment of MedicineCollege of MedicineFaculty of MedicineQatif Central HospitalAbdulmajeed Al Khathami,1,&ast; Mohamed Baklola,2,&ast; Anwar Ali Alshehri,3 Lujain Hussain Alnasser,4 Razan Saleh Alshehri,5 Mohammed A Salawi,6 Rahaf Hussain Alwadai,7 Mohammed Al Ghazwi,8 Amira Ahmed Qadim Alanazi,9 Asayel Mojidea Alshammari,10 Naji Al-bawah,11,&ast; Mayas Hafez,12 Abdullah Abu Melha1 1Department of Ophthalmology, King Fahad Hospital, Al Baha Health Cluster, Al Baha, Saudi Arabia; 2Faculty of Medicine, Mansour University, Mansoura, Egypt; 3College of Medicine, University of Bisha, Bisha, Saudi Arabia; 4College of Medicine, University of Hail, Hail, Saudi Arabia; 5Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam, Saudi Arabia; 6College of Medicine, Taif University, Taif, Saudi Arabia; 7College of Medicine, Najran University, Najran, Saudi Arabia; 8Batterjee Medicine college, Jeddah, Saudi Arabia; 9College of Medicine, Northern Border University, Arar, Saudi Arabia; 10College of Medicine, Aljouf University, Aljouf, Saudi Arabia; 11Faculty of Medicine, Sana’a University, Sana’a, Yemen; 12Qatif Central Hospital, Al Qatif, 32654, Saudi Arabia&ast;These authors contributed equally to this workCorrespondence: Naji Al-bawah, Email Najialbawah@gmail.com Mohamed Baklola, Email Mohamedbaklola2000@gmail.comBackground: Refractive errors, including myopia, hyperopia, and astigmatism, are a leading cause of visual impairment among children worldwide. In Saudi Arabia, the prevalence of these conditions among school-age children and adolescents remains poorly understood, with significant variations reported across studies. This systematic review and meta-analysis aimed to provide a comprehensive estimate of the pooled prevalence of refractive errors in this population and explored factors influencing their distribution.Methods: A systematic search of PubMed, Scopus, Web of Science, and ScienceDirect was conducted in accordance with PRISMA 2020 guidelines. Observational studies reporting the prevalence of refractive errors among Saudi school-aged children and adolescents were included. Data extraction and quality assessment were conducted using the Newcastle-Ottawa Scale. Pooled prevalence estimates with 95% confidence intervals (CIs) were calculated using a random-effects model, and heterogeneity was assessed with the I² statistic.Results: Nine studies including over 15,000 participants were analyzed. The pooled prevalence of myopia was 6.7% (95% CI: 3.0% to 14.2%), hyperopia was 3.6% (95% CI: 1.3% to 9.8%), and astigmatism was 7.7% (95% CI: 2.5% to 20.9%). Subgroup analysis revealed regional disparities, with the highest myopia prevalence reported in Taif (33.3%) and Bisha (22.5%), and the lowest in Medina (1.6%). Studies conducted after 2018 showed a significantly higher pooled myopia prevalence (16.4%, 95% CI: 8% to 30.5%) compared to those published before 2018 (3.3%, 95% CI: 1.4% to 7.5%) (p < 0.001). While studies using cycloplegic refraction reported a slightly higher myopia prevalence (7.2%, 95% CI: 4.7% to 11%) than those using non-cycloplegic methods (6.7%, 95% CI: 2.4% to 17.5%), the difference was not statistically significant (p = 0.9). No significant difference was observed between studies with smaller or larger sample sizes, although high heterogeneity persisted across all subgroups.Conclusion: Refractive errors, particularly astigmatism, represent a significant and growing public health issue among Saudi school-aged children and adolescents. The findings underscore the urgent need for standardized diagnostic protocols, including the use of cycloplegic refraction, and the implementation of school-based vision screening programs.Keywords: myopia, hyperopia, astigmatism, refractive errors, childrenhttps://www.dovepress.com/prevalence-of-refractive-errors-among-school-age-children-and-adolesce-peer-reviewed-fulltext-article-OPTHMyopiaHyperopiaAstigmatismRefractive errorschildren |
| spellingShingle | Al Khathami A Baklola M Alshehri AA Alnasser LH Alshehri RS Salawi MA Alwadai RH Al Ghazwi M Alanazi AAQ Alshammari AM Al-bawah N Hafez M Abu Melha A Prevalence of Refractive Errors Among School-Age Children and Adolescents in Saudi Arabia: A Systematic Review and Meta-Analysis Clinical Ophthalmology Myopia Hyperopia Astigmatism Refractive errors children |
| title | Prevalence of Refractive Errors Among School-Age Children and Adolescents in Saudi Arabia: A Systematic Review and Meta-Analysis |
| title_full | Prevalence of Refractive Errors Among School-Age Children and Adolescents in Saudi Arabia: A Systematic Review and Meta-Analysis |
| title_fullStr | Prevalence of Refractive Errors Among School-Age Children and Adolescents in Saudi Arabia: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Prevalence of Refractive Errors Among School-Age Children and Adolescents in Saudi Arabia: A Systematic Review and Meta-Analysis |
| title_short | Prevalence of Refractive Errors Among School-Age Children and Adolescents in Saudi Arabia: A Systematic Review and Meta-Analysis |
| title_sort | prevalence of refractive errors among school age children and adolescents in saudi arabia a systematic review and meta analysis |
| topic | Myopia Hyperopia Astigmatism Refractive errors children |
| url | https://www.dovepress.com/prevalence-of-refractive-errors-among-school-age-children-and-adolesce-peer-reviewed-fulltext-article-OPTH |
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