Prevalence of refractive errors in urban school children in India: The Hyderabad Eye Study

Padmaja Sankaridurg, Krupa Philip, Nagaraju Konda, Kalika Bandamwar, Swathi Kanduri, Jaya Sowjanya Siddireddy, Brien A. Holden

Research output: Contribution to conference (non-published works)Abstractpeer-review


Purpose: To determine the prevalence of refractive errors in urban schoolchildren from Hyderabad, India.

Methods: Prospective, cross-sectional evaluation of the ocular health of a sample of urban school children from Hyderabad,India. Five schools from various zones of Hyderabad were randomly selected and all children aged 6 to 15 yrs(n=2347) were considered. Informed consent was obtained from all children. Following unaided, aided visual acuity and slit lamp biomicroscopy, eyes were cyclopleged with 1% tropicamide. Following cycloplegia, autorefraction,subjective refraction and posterior segment evaluation with direct ophthalmoscopy was conducted. Using data from worst eye, myopia was defined as cycloplegic spherical equivalent ≤-0.50D, emmetropia as >-0.50D to +0.50D and hyperopia of ≥ +0.50D. Astigmatism was a cylindrical refractive error of ≥1.0D. Prevalence and 95% confidence intervals (CI) are presented. Influence of gender, age and school on myopia was assessed using logistic regression.

Results: Of the 2347 participants, data for 2259 eligible children (11.3 ± 2.3 yrs) was considered. Prevalence of myopia, hyperopia, astigmatism and emmetropia with cycloplegic autorefraction was 35.5%(CI:33.5-37.4),14.6%(CI:13.1-16.0), 3.6%(CI:2.9-4.4) and 46.3%(CI:44.3-48.4) respectively and with subjective refraction was 21.3%(CI:19.6-23.0), 4.5%(CI:3.6-5.3), 3.5%(CI:2.8-4.3) and 70.7%(CI:68.8-72.5) respectively. Difference in the prevalence of refractive error between cycloplegic autorefraction and subjective refraction was due to children preferring no correction over low levels of myopic,astigmatic as well as hyperopic prescriptions. Myopia was associated with age (p<0.001) and school (p=0.032) but not gender. Myopia increased with age with a prevalence of 17.4%, 34.4%, 46.6% and 39.4% for ages 6,10,12 and 14 respectively. For the 5 schools, myopia prevalence ranged between 26% to 47.4%. The school with the highest prevalence had children with parents from a middle to low socioeconomic status. Prevalence of high myopia (≤-6.00D) was 0.8%(CI:0.4-1.2).

Conclusions: Compared to previous studies, a greater prevalence of myopia was found in urban school children in Hyderabad. This shift reflects the global trend towards increasing myopia prevalence and indicates a need for public health policies and strategies around eye health to avoid uncorrected refractive error and to reduce the prevalence and progression of myopia.
Original languageEnglish
Number of pages1
Publication statusPublished - 15 Jun 2015
Externally publishedYes
EventARVO Annual Meeting - Colorado Convention Center (CCC), Denver, United States
Duration: 3 May 20157 May 2015


ConferenceARVO Annual Meeting
Country/TerritoryUnited States
Internet address


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