Prevalence of high myopia and its associated factors among secondary school students at Finote-selam town, Northwest Ethiopia, 2023.

High myopia is a severe form of myopia defined as a refractive error of –6.00 diopters or more associated with a high risk of irreversible visual impairment and blindness. However, data on its magnitude and determinants among school-aged children in Ethiopia are scarce. This school-based cross-sectional study was conducted from May 10 to June 10, 2023, among 408 secondary school students in Finote-Selam town, Northwest Ethiopia, selected using systematic random sampling. Data were collected using a pretested structured questionnaire, and refraction was assessed through dry retinoscopy followed by subjective refraction. High myopia was defined as a spherical equivalent refractive error of ≥−6.00 diopters in either eye. Data were entered into EpiData 4.6 and analyzed using SPSS version 25. Variables with a p-value < 0.05 in the multivariable analysis were considered statistically significant. The prevalence of high myopia was 3.77% (95% CI: 1.90–5.70). Factors significantly associated with high myopia included a family history of myopia (AOR = 2.80; 95% CI: 1.46–20.02), ocular comorbidity (AOR = 5.02; 95% CI: 1.40–18.06), low outdoor activity (AOR = 3.68; 95% CI: 1.20–11.29), and prolonged near-work activity (AOR = 5.25; 95% CI: 1.13–24.46). High myopia was present among a notable proportion among secondary school students, and both genetic and behavioral factors contributed to its occurrence. Promoting outdoor activities, monitoring high-risk individuals, limiting excessive near-work, and managing ocular comorbidities are recommended to reduce the burden of high myopia.