Childhood visual impairment in Qassim region of Saudi Arabia prevalence causes and risk factors.

To assess the prevalence of childhood visual impairment and refractive errors, as well as the causes and risk factors associated with visual impairment among children in the Qassim region of Saudi Arabia. This cross-sectional study included 850 children (aged 6-17 years) from six randomly selected primary schools in the Qassim region, conducted from March to May 2024. The study used the modified Refractive Error Study in Children (RESC) protocol. Refractive error was objectively assessed using a non-cycloplegic autorefractometer. Anterior eye examinations were performed using slit lamp biomicroscopy, while posterior segment examinations were conducted using a direct ophthalmoscope and 90 D fundus biomicroscopy. Visual impairment was classified according to the International Classification of Diseases, 11th revision (ICD-11), 2018. The prevalence of presenting childhood visual impairment was 25.5%, reduced to 7.1% with best correction. Presenting visual impairment included mild impairment in 15.5% of participants, moderate in 6.4%, severe in 2.1%, and 1.5% were classified as blind. The leading cause of childhood visual impairment was uncorrected refractive error (67.3%), followed by amblyopia (23.0%); cataract (5.5%); and congenital disorders (5.1%). The prevalence of hyperopia, myopia, and astigmatism were 30.5%, 19.3%, and 11.3%, respectively. The regression analysis showed that males had lower odds of visual impairment compared to females (OR: 0.57; P = 0.001). Children who never had their eyes checked had lower odds of visual impairment compared to those who had regular eye examinations (OR: 0.32; P < 0.001). Additionally, emmetropic children had lower odds of visual impairment compared to those with uncorrected refractive errors (OR: 0.22; P < 0.001). This study found a high prevalence of childhood visual impairment and refractive errors, with uncorrected refractive errors being the leading cause. Regular eye examinations and corrective measures are essential. Males had lower odds of visual impairment compared to females. These findings highlight the need for targeted interventions to enhance eye care services and reduce visual impairment in children.