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 Table of Contents 
ORIGINAL ARTICLE
Year : 2020  |  Volume : 9  |  Issue : 7  |  Page : 3277-3280  

Knowledge, attitude, and practice about myopia in school students in Marat city of Saudi Arabia


1 Medical Student, Department of Clinical Sciences, Shaqra University, Shaqra, Saudi Arabia
2 Department of Pharmacology, College of Medicine, Shaqra University, Shaqra, Saudi Arabia

Date of Submission14-Jan-2020
Date of Decision12-Mar-2020
Date of Acceptance24-Mar-2020
Date of Web Publication30-Jul-2020

Correspondence Address:
Mr. Anas Abdulaziz Almujalli
Medical Student, College of Medicine, Shaqra University, Shaqra - 11961
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jfmpc.jfmpc_86_20

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  Abstract 


Background: The prevalence of youth myopia has increased significantly in the local communities of Saudi Arabia; school children and parents are unaware of the knowledge and complications of myopia. Objective: To initiate and increase the awareness of myopia among school students and to prevent future complications. Method: An organized, questionnaire with 14 questions was prepared to analyze the school students' knowledge attitudes and practice about myopia. The study was conducted in a local school in Marat city, Saudi Arabia, between April 2019 and September 2019. The sample size includes 100 male students of age group 7 years to 14 years. Results: 82% of students have heard about myopia with the majority source of information being parents (62%) and teachers (35%). 45% of the students reported a negative attitude toward the eye-glasses users. 20% of students have reported the use of eye-glasses. Most of the students reported uncomfortable feel and shyness due to wearing of eye-glasses which limits their use. Conclusion: The public awareness programs by the local governing bodies, local hospitals, health workers, medical colleges, and non-government organizations should be organized in each local school to increase the school students' knowledge, positive attitude, and practice toward myopia.

Keywords: Electronic devices, eye-glasses, local areas, myopia, school children


How to cite this article:
Almujalli AA, Almatrafi AA, Aldael AA, Almojali HA, Almujalli AI, Pathan A. Knowledge, attitude, and practice about myopia in school students in Marat city of Saudi Arabia. J Family Med Prim Care 2020;9:3277-80

How to cite this URL:
Almujalli AA, Almatrafi AA, Aldael AA, Almojali HA, Almujalli AI, Pathan A. Knowledge, attitude, and practice about myopia in school students in Marat city of Saudi Arabia. J Family Med Prim Care [serial online] 2020 [cited 2020 Aug 14];9:3277-80. Available from: http://www.jfmpc.com/text.asp?2020/9/7/3277/290850




  Introduction Top


Myopia is the state of refraction in which parallel rays of light are brought to focus in front of the retina of a resting eye. Myopia is measured by the spherical power in diopters of the diverging lens needed to focus light onto the retina, which can be expressed as the spherical equivalent or refraction in the least myopic meridian. The clinical correlates of myopia include blurred distance vision, eye rubbing, and squinting. Myopia has been classified as either physiologic or pathologic. Physiologic myopia occurs due to an increase in the axial diameter of the eye over that which is attained by normal growth. Pathologic myopia is caused by an abnormal lengthening of the eyeball and is often associated with thinning of the scleral wall. Another classification is based on the age of onset. Congenital or infantile myopia occurs at birth with a reported prevalence in the full-term newborn varying from 0.0 to 24.2 percent. This variability is due to the technical difficulties in measuring the refraction in newborns. School myopia occurs at approximately 7–17 years of age and stabilizes by the late teens or early twenties. Both school and adult-onset myopia are mainly the results of idiopathic causes, while congenital myopia is often associated with other abnormalities.[1],[2],[3],[4],[5],[6]

Severe myopia may be associated with myopic macular degeneration, cataract, glaucoma, peripheral retinal changes (such as lattice degeneration), and retinal holes and tears, as well as retinal detachment. The methods of myopia correction are not without complications, including corneal infections due to contact lens wear and corneal scarring and persistent corneal haze from refractive surgery. The public health and economic impact of myopia, the most common eye condition in the world, is enormous. In the United States, the cost of correcting refractive errors with spectacles or contact lenses is estimated to be 2 billion dollars per year. Thus, myopia is a condition with social, educational, and economic consequences. Over the past few decades, there has been an increase in the prevalence of myopia in some populations, leading to growing concern among the public and the scientific community. The Chinese and Japanese appear to have had escalations of myopia rates. There is no well-established or universally accepted treatment for the prevention of myopia onset or progression. Some research studies indicated that the outdoor time helps slowdown the change of axial length and reduce the risk of myopia in the children.[7],[8],[9],[10],[11],[12],[13],[14]

Myopia is often considered benign because it is easily corrected with glasses, contact lenses, or refractive surgery. However, the prevalence of myopia is rapidly increasing in East Asia, and the large social costs spent to correct myopia make the disorder a serious public health issue. Furthermore, high myopia cannot be completely corrected and causes critical vision-threatening pathologies as well as blindness.[15],[16],[17]


  Method Top


An organized questionnaire was prepared to analyze school students' knowledge on the attitude and practice about myopia. The study was conducted in a local school in Marat city, Saudi Arabia, during the months of April 2019 to September 2019. The sample size includes 100 male students of age group 7 years to 14 years. The questions were selected by the research team drafted in English and Arabic. The aim of the study and questionnaire were described to the contributors. Medical students were assigned to conduct the study in different places. The names of the contributors were kept confidential to encourage accurate responses. Data were analyzed by a statistical analysis system. Variables were assessed using the Chi-square test. Statistical significance was defined as P values of < 0.05.

The study design and protocol was approved by the local institutional review board with number: SUCOM/LIRB/2019-06


  Results Top


The study analyzed 100 students from different age groups. 45% of students were aged 7 to 9; 25% of the students were aged 10 to 12, and 30% of the students were aged 13 to 14. 88% of study contributors were Saudi nationals [Table 1].
Table 1: Demographic data

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82% of the students have heard about myopia with the majority source of information being parents (62%) and teachers (35%). 24% of the students suffered from myopia with 57% of students have a family history of myopia. Frequent use of electronic devices (52%) and malnutrition (25%) was the major cause of myopia in student's minds. 20% of students have reported the use of eye-glasses. Most of the students reported uncomfortable feel and shyness due to wearing of eye-glasses which limits their use. 45% of the students reported a negative attitude towards the eye-glasses users. 49% of the students were using electronic devices for less than 2 hours. 11% of the students took regular follow-up for the optics clinic. In the students' view, the limited use of electronic devices and the wearing of eye-glasses will treat myopia [Table 2].
Table 2: Questionnaires on myopia and percentage of response

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Public awareness programs by the local governing bodies, local hospitals, health workers, medical colleges, and non-government organizations should be organized in each local school to increase the school student knowledge, positive attitude, and practice towards myopia.


  Discussion Top


Myopia is a major public health problem. Myopia prevalence was reported to be increasing, with up to 80% of the junior school students with myopia in East Asia. However, the common challenges in implementing the myopia control strategies on a national level included lack of primary care and school screening programmes and the paucity of accurate prevalence data. There continues to be broad public misconception about myopia and myopia control, including the lack of parental awareness and resistance to wearing spectacles. We recommend to increase public education to raise parent and teacher awareness through primary health care workers including the spectacle dispensing for myopia at primary eye care level; encouragement of increased outdoor time of 2–3 hours per day for schoolchildren as a practical public health and primary care intervention that has been shown to potentially reduce the onset and progression of myopia. Governments and non-governmental organizations are encouraged to collaborate, especially education and health ministries to develop national myopia prevention programmes in primary care. Lastly, it is important to emphasize that the key recommendations, such as increasing the outdoor time for school children.[18],[19],[20]

Acknowledgements

The authors are thankful to Shaqra University, Ministry of Education, Kingdom of Saudi Arabia for providing a platform to encourage research and developments among the students, staff, and society.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Arevalo JF, Lasave AF, Torres F, Suarez E. Rhegmatogenous retinal detachment after LASIK for myopia of up to -10 diopters: 10 years of follow-up. Graefes Arch Clin Exp Ophthalmol 2012;250:963-70.  Back to cited text no. 1
    
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Bourne RR, Stevens GA, White RA, Smith JL, Flaxman SR, Price H, et al. Causes of vision loss worldwide, 1990–2010: A systematic analysis. Lancet Glob Health 2013;1:e339-49.  Back to cited text no. 3
    
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Fan DS, Lam DS, Lam RF, Lau JT, Chong KS, Cheung EY, et al. Prevalence, incidence, and progression of myopia of school children in Hong Kong. Invest Ophthalmol Vis Sci 2004;45:1071-5.  Back to cited text no. 5
    
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Fan DSP, Cheung EYY, Lai RYK, Kwok AKH, Lam DSC. Myopia progression among preschool Chinese children in Hong Kong. Ann Acad Med Singap 2004;33:39-43.  Back to cited text no. 6
    
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Cai XB, Shen SR, Chen DF, Zhang Q, Jin ZB. An overview of myopia genetics. Exp Eye Res 2019;188:107778.  Back to cited text no. 7
    
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Jonas JB, Panda-Jonas S. Epidemiologie und anatomie der Myopie. Epidemiology and anatomy of myopia. Ophthalmologe 2019;116:499-508.  Back to cited text no. 8
    
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Schaeffel F. Prävention der Myopie. Prevention of myopia. Ophthalmologe 2019;116:509-17.  Back to cited text no. 9
    
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Jonas JB. Myopie: Myopia: Epidemiology, anatomy and prevention of myopia and treatment options for progressive myopia in childhood. Ophthalmologe 2019;116:498.  Back to cited text no. 11
    
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Prousali E, Haidich AB, Fontalis A, Ziakas N, Brazitikos P, Mataftsi A. Efficacy and safety of interventions to control myopia progression in children: An overview of systematic reviews and meta-analyses. BMC Ophthalmol 2019;19:106.  Back to cited text no. 12
    
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Cao K, Wan Y, Yusufu M, Wang N. Significance of outdoor time for myopia prevention: A systematic review and meta-analysis based on randomized controlled trials. Ophthalmic Res 2020;63:97-105.  Back to cited text no. 13
    
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Grzybowski A, Kanclerz P, Tsubota K, Lanca C, Saw SM. A review on the epidemiology of myopia in school children worldwide. BMC Ophthalmol 2020;20:27.  Back to cited text no. 14
    
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Wu HM, Seet B, Yap EP, Saw SM, Lim TH, Chia KS. Does education explain ethnic differences in myopia prevalence? A population-based study of young adult males in Singapore. Optom Vis Sci 2001;78:234-9.  Back to cited text no. 15
    
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Yamada M, Hiratsuka Y, Roberts CB, Pezzullo ML, Yates K, Takano S, et al. Prevalence of visual impairment in the adult Japanese population by cause and severity and future projections. Ophthalmic Epidemiol 2010;17:50-7.  Back to cited text no. 16
    
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Zheng YF, Pan CW, Chay J, Wong TY, Finkelstein E, Saw SM. The economic cost of myopia in adults aged over 40 years in Singapore. Invest Ophthalmol Vis Sci 2013;54:7532-7.  Back to cited text no. 17
    
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Ang M, Flanagan JL, Wong CW, Müller A, Davis A, Keys D, et al. Review: Myopia control strategies recommendations from the 2018 WHO/IAPB/BHVI meeting on myopia. Br J Ophthalmo. 2020. pii: bjophthalmol-2019-315575. doi: 10.1136/bjophthalmol-2019-315575. [Epub ahead of print]  Back to cited text no. 18
    
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Karuppiah V, Wong L, Tay V, Ge X, Kang LL. School-based programme to address childhood myopia in Singapore. Singapore Med J 2019. doi: 10.11622/smedj. 2019144. [Epub ahead of print]  Back to cited text no. 19
    
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Ravilla ST, Ramasamy D. Spectacle dispensing for myopia at primary eye care level. Community Eye Health 2019;32:S3-S4.  Back to cited text no. 20
    



 
 
    Tables

  [Table 1], [Table 2]



 

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