Prevalence of myopia and its risk factors in rural school children in North India: the North India myopia rural study (NIM-R Study)

Abstract

Background: To assess the prevalence of myopia and its risk factors in rural school children.

Methods: Children in classes 4-7 of eight randomly selected schools (five government and three private) in rural Haryana, with unaided vision <6/9.5 were screened, their cycloplegic refraction is done, myopes were identified. A questionnaire-based assessment of risk factors was done for myopes and compared with 10% of randomly selected children with normal vision (controls). The prevalence of myopia and its association with risk factors were assessed.

Results: Children screened were 1486 (89.5% coverage). The mean age of children was 11.2 ± 1.5 years with 861 (57.9%) boys. Prevalence of myopia was 6.4% (95% Confidence intervals [CI]: 5.2%, 7.8%). Prevalence was higher among private schools (10.1%) compared to government schools (1.4%) (p < 0.001), and among girls 7.2% (45/625) compared to boys 5.8% (50/861) (p = 0.2786). The mean spherical equivalent refractive error was -1.61D ± 1.32D. The prevalence of high myopia was 1.1% (1/95). There was a 75% unmet need for spectacles. Studying in private school was positively associated with myopia as per our multivariate analysis (p = 0.016). An inverse association was found for time spent outdoors (p = 0.009). Watching television, indoor time, screen time, age, or gender were not found to be statistically significant as risk factors.

Conclusion: The prevalence of myopia is increasing among children of rural areas, especially those in private schools with a strong inverse association with time spent outdoors. Regular screening, lifestyle modification and awareness about modifiable risk factors are essential.