Myopia Prevalence and Associated Factors IN School-Aged Children in Southern Morocco: A Cross-Sectional Study

Abstract

Myopia is one of the leading causes of visual impairment worldwide, typically beginning during the school-age years. Several factors contribute to its development, including environmental influences, excessive use of digital devices, and limited outdoor activities. The objective of this study was to assess the prevalence of myopia and associated factors among school-aged children and adolescents in rural areas of southern Morocco. A cross-sectional study was conducted between November 2022 and January 2023, involving 342 participants, with a majority of boys (54.4%) and a mean age of 13 years. Data were collected using a questionnaire that gathered sociodemographic and vision-related information, followed by a vision test to determine myopia status using cycloplegic autorefraction. The results revealed a relatively low prevalence of myopia (11%, 95% CI: 7.8%-14.4%). Multivariate logistic regression showed that a screen-watching distance less than 35 cm was significantly associated with an increased risk of myopia (OR = 1.89; 95% CI: 1.02-3.47; p = 0.042). The majority of participants (98%) reported spending at least two hours outdoors daily, and the average daily use of digital devices was 30 minutes. Interestingly, the majority of participants (72%) maintained a screen viewing distance of ≥35 cm, which was found to be associated with myopia (p = 0.04). This may reflect a behavioral adaptation rather than a direct causal relationship. Overall, the study suggests that the low prevalence of myopia in this population may be attributed to high exposure to daylight and limited use of digital devices. These findings underscore the potential protective role of outdoor activities and highlight the need for further research to better understand the factors influencing myopia development in rural populations.