Prevalence, causes, and associated risk factors of vision impairment among children at Ibn Al-Haitham Teaching Hospital in Baghdad, Iraq

Abstract

Visual impairment in children is a significant public health concern, particularly in developing countries, where it represents a major aspect of youth disabilities. This study investigated the prevalence, causes, and risk factors associated with visual impairment (VI) and refractive errors among children attending the Ibn Al Haitham Teaching Eye Hospital in Baghdad, Iraq. A total of 606 children aged 6–15 years attending the hospital were invited to participate in the study. Participants underwent eye examinations, comprising of visual acuity assessments using distance and near LogMAR charts, objective and subjective refraction. A structured interview questions was administered to their parents to determine the risk factors associated with visual impairment and refractive error. Visual impairment was determined using the World Health Organization International Classification of Disease-11. A total of 508 participants were included in the analysis, and mean age was 9.31 ± 2.69 years. The prevalence of VI was 18.7% and the leading causes were uncorrected refractive error (49.5%), cataract (20.0%), and amblyopia (13.7%). Majority of the children had myopia (53.1%), followed by hyperopia (17.3%) and astigmatism (9.4%), and 42.1% had anisometropia. Multivariate logistic regression was used to determine the risk factors of vision impairment and refractive error. The only significant risk factor of VI was living in urban areas (p=0.001). Additionally, children whose fathers had secondary education or tertiary education, and with history of myopia were at lesser odds of having VI (p<0.001). Risk factors associated with increase myopia was watching television for ≥2 hours (p=0.018), for hyperopia, watching television at a distance ≥3 meters (p< 0.001) and for astigmatism, residing in urban areas and studying <4 hours (p=<0.001). These findings underscore the urgent need for comprehensive public health interventions by the government and Ministry of Health to address the burden of visual impairment among Iraqi children. Strategies should focus on improving access to affordable and quality eye care