Evaluation of pre-myopia risk factors in children aged 6-10 years: pediatric vision screening
Abstract
Background: The aim of this study was to evaluate pre-myopia risk factors in children aged 6–10 years and to investigate whether a simple risk-based questionnaire could help identify children at increased risk of pre-myopia in primary healthcare settings. Methods: This cross-sectional study was conducted in Erzurum, Türkiye, over a three-week period beginning on October 28, 2025. A total of 652 children were invited to participate in the study; those with active visual complaints and those not within the 6–10 age range were excluded. A total of 453 children who met the inclusion criteria were analyzed. Based on questionnaire scores, low-, medium-, and high-risk groups were formed; biometric measurements of 44 children in the high-risk group who attended the examination were evaluated. The relationships between risk groups and demographic variables were analyzed using the chi-square test, and the relationship between biometric parameters and SE was assessed using Pearson correlation. An AL/CR ratio ≥ 2.90 was accepted as the biometric high-risk threshold. Sample adequacy was verified using G*Power 3.1. Results: The mean age was 7.91 ± 1.26 years, and 51.7% of participants were male. The mean AL/CR ratio in the examined children was 2.90 ± 0.12. SE values ranged from −0.50 to +0.50 D, indicating that all examined children were within the refractive pre-myopia range. No significant correlation was found between questionnaire risk score and AL/CR ratio (Pearson r = −0.08, p = 0.666) or SE (Pearson r = −0.11, p = 0.535). Questionnaire risk score was not a significant predictor of an AL/CR ratio ≥2.90 in univariable logistic regression analysis (OR = 1.14, 95% CI: 0.64–2.03; p = 0.67). Conclusion: The findings suggest that a simple risk-based questionnaire may assist primary care physicians in identifying children who could benefit from ophthalmologic evaluation. Further validation studies are required before routine implementation.