Refractive Errors and Their Associated Factors in Schoolchildren: A Structural Equation Modeling

This study investigates the prevalence of myopia and hyperopia in schoolchildren in Shahroud, Iran and the risk factors of these conditions.

Optometric examinations including the measurement of uncorrected and corrected visual acuity as well as non-cycloplegic and cycloplegic refraction using retinoscopy were done for students.

The data of 5581 students with a mean age of 9.24 ± 1.7 years were used in this study. The prevalence of myopia was 5.0% (95%CI: 4.3–5.7) and the prevalence of hyperopia was 4.8% (95%CI: 4.0 − 5.5) in all schoolchildren. According to the GSEM results, the odds of myopia in rural areas were 0.55 compared to urban areas. The interaction of sex and age on myopia was significant such that in girls, the odds of myopia increased by 20% for every one-year increase in age while no significant change was seen in boys. A one-unit increase in the ocular AL decreased the odds of hyperopia by 0.49 times. Moreover, the interaction of outdoor activity hours and sex on the prevalence of hyperopia was significant such that increased outdoor activity reduced the odds of hyperopia in girls while no significant correlation was found in boys.

Publication date

March 26, 2022


Ophthalmic Epidemiology


Hassan Hashemi; Mehdi Khabazkhoob; Mahsa Fayaz; Mohammed Hassan Emamian; Abbasali Yekta; Rafael Iribarren; Akbar Fotouhi.
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