Astigmatism among children in Jeddah, Saudi Arabia: prevalence and associated factors

Background: Undiagnosed astigmatism among children may result in multiple unfavourable consequences, such as poor performance on cognitive and language tasks, reduced oral reading fluency, behavioural disorders, and amblyopia development. In contrast, astigmatism is easily correctable in young children, which highlights the need for periodic assessment of its prevalence among pediatric populations. Purpose: This study aimed to assess the prevalence of astigmatism among the pediatric population in Jeddah, Saudi Arabia, and to assess the rate of newly detected cases (incidental astigmatism) and the associated risk factors. Patients and methods: This cross-sectional study was conducted among visitors of the awareness campaign about amblyopia, which took place in the Red Sea Mall, Jeddah, Saudi Arabia, on January 29-30, 2016. Children aged 2-15 years were enrolled in the study to undergo noncycloplegic eye examination using an autorefractometer for measuring cylindrical refractive error (Cyl). The calculated sample size for the studied age group of the population of Jeddah, Saudi Arabia was 291. Astigmatism was defined as Cyl >= 1 diopter in either eye. Multivariate binomial regression was used to analyze the predictors of incidental astigmatism. Results: We examined the eyes of 347 children, mean age = 7.788 (standard deviation = 2.69) years, females = 53.3%. The overall prevalence of astigmatism was 41.5%, whereas the prevalence of incidental astigmatism was 40.6% among 342 children without apparent astigmatism. The prevalence of incidental astigmatism was associated with a previous diagnosis of amblyopia, having a sibling known to have amblyopia, and wearing spectacles. However, only wearing spectacles was shown to predict incidental astigmatism in the multivariate analysis. Conclusion: Astigmatism is highly prevalent among children in Western Saudi Arabia, with the majority being undiagnosed before this screening campaign. These findings urge for further nationwide, population-based studies to address the burden of refractive errors among children in Saudi Arabia.