{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:57:13Z","timestamp":1790575033980,"version":"4.1.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Ophthalmol."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe the clinic-based distribution of myopia, hyperopia, and astigmatism among young Iraqi adults and to examine demographic, social, familial, and self-reported behavioral factors associated with myopia and high-severity refractive errors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This multicenter, clinic-based, cross-sectional study included 4,340 consecutive young adult attendees at three tertiary ophthalmic centers. Right-eye sphere and cylinder values were standardized to minus-cylinder notation before spherical equivalent (SE), and refractive outcomes were derived. Subgroup percentages were calculated using the relevant subgroup denominator, and multivariable logistic regression was used to evaluate associated factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the analytic sample, myopia (SE \u2264 \u22120.50 D) occurred in 51.2%, hyperopia (SE \u2265 +0.50 D) in 37.0%, and astigmatism (|cylinder| \u2265 0.50 D) in 66.4%; astigmatism overlapped with spherical refractive status. Myopia was more frequent among women than men (53.6% vs 45.6%). In the adjusted model, female sex, age 28\u201332 years, a positive family history of refractive error, sleep duration \u22646 hours, and longer daily electronic-device use were associated with higher odds of myopia, whereas office work, manual work, and unemployment were associated with lower odds than student status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Refractive errors were frequent among young adults attending tertiary ophthalmic clinics in Iraq. The observed associations with demographic, familial, social, and behavioral factors provide clinically useful information for targeted refractive assessment, counseling, and service planning in young adults. Population-based longitudinal studies are needed to confirm the generalizability and temporal nature of these associations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fopht.2026.1904325","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:44:41Z","timestamp":1790574281000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Distribution and factors associated with refractive errors among young adults attending ophthalmic clinics in Iraq: a multicenter cross-sectional study"],"prefix":"10.3389","volume":"6","author":[{"given":"Hassan A.","family":"Aljaberi","sequence":"first","affiliation":[{"name":"Optical Techniques Department, College of Health and Medical Techniques, Al-Mustaqbal University","place":["Babylon, Iraq"]},{"name":"Department of Optometry Techniques, College of Health and Medical Techniques, Al-Furat Al-Awsat Technical University","place":["Najaf, Iraq"]},{"name":"Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences","place":["Tehran, Iran"]},{"name":"International Campus, Shahid Beheshti University of Medical Sciences","place":["Tehran, Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeed","family":"Rahmani","sequence":"additional","affiliation":[{"name":"Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences","place":["Tehran, Iran"]},{"name":"International Campus, Shahid Beheshti University of Medical Sciences","place":["Tehran, Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Ayatollahi","sequence":"additional","affiliation":[{"name":"Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences","place":["Tehran, Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30425-3","article-title":"Trends in prevalence of blindness and distance and nearvision impairment over 30 years: an analysis for the GlobalBurden of Disease Study","volume":"9","author":"Jd","year":"2021","journal-title":"Lancet Glob Heal"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/s2214-109x(17)30393-5","article-title":"Global causes of blindness and distance vision impairment 1990-2020","volume":"5","author":"Flaxman","year":"2017","journal-title":"A Syst Rev meta-analysis Lancet Glob Heal"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1177\/0264619620972154","article-title":"The certification of vision impairment: a regional 21st century perspective","volume":"41","author":"Jackson","year":"2023","journal-title":"Br J Vis Impair"},{"key":"B4","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1186\/s12886-025-04162-0","article-title":"Correlation between refractive errors and ocular biometric parameters at Al-Mustaqbal University, Iraq","volume":"25","author":"Aljaberi","year":"2025","journal-title":"BMC Ophthalmol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S523283","article-title":"The role of scleral changes in the progression of myopia: a review and future directions","volume":"19","author":"Yin","year":"2025","journal-title":"Clin Ophthalmol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1080\/08164622.2025.2589400","article-title":"Correlation between axial length and refractive error in emmetropic and myopic Iraqi adults","volume":"109","author":"Aljaberi","year":"2026","journal-title":"Clin Exp Optom"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.64.6.6","article-title":"IMI\u2014Global trends in myopia management attitudes and strategies in clinical practice\u20142022 update","volume":"64","author":"Wolffsohn","year":"2023","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2016.01.006","article-title":"Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050","volume":"123","author":"Holden","year":"2016","journal-title":"Ophthalmology"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.2174\/18743641-v17-e230214-2022-36","article-title":"Contact lens as drug delivery system for glaucoma treatment: a review","volume":"17","author":"Aljaberi","year":"2023","journal-title":"Open Ophthalmol J"},{"key":"B10","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.ajo.2013.08.010","article-title":"Epidemiology and disease burden of pathologic myopia and myopic choroidal neovascularization: an evidence-based systematic review","volume":"157","author":"Wong","year":"2014","journal-title":"Am J Ophthalmol"},{"key":"B11","article-title":"The impact of myopia and high myopia","year":"2015","journal-title":"World Heal Organ Holden Vis Inst"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.preteyeres.2017.09.004","article-title":"The epidemics of myopia: aetiology and prevention","volume":"62","author":"Morgan","year":"2018","journal-title":"Prog Retin Eye Res"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.66.7.4","article-title":"Perspectives on genetic and environmental factors in myopia, its prediction, and the future direction of research","volume":"66","author":"Williams","year":"2025","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.66.12.39","article-title":"IMI\u2014Interventions for controlling myopia onset and progression 2025","volume":"66","author":"Bullimore","year":"2025","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.21037\/tp-2025-409","article-title":"Effects of genetic factors and visual behaviors on interventions for myopia prevention and control in children: a systematic review and meta-analysis","volume":"14","author":"Xie","year":"2025","journal-title":"Transl Pediatr"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD013549","article-title":"Interventions to increase time spent outdoors for preventing incidence and progression of myopia in children","volume":"2020","author":"Kido","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1111\/opo.12657","article-title":"The association between digital screen time and myopia: a systematic review","volume":"40","author":"Lanca","year":"2020","journal-title":"Ophthalmic Physiol Opt"},{"key":"B18","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.joco.2018.08.001","article-title":"Prevalence of refractive errors in Iranian university students in Kazerun","volume":"32","author":"Hashemi","year":"2020","journal-title":"J Curr Ophthalmol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.joco.2017.08.009","article-title":"Global and regional estimates of prevalence of refractive errors: systematic review and meta-analysis","volume":"30","author":"Hashemi","year":"2018","journal-title":"J Curr Ophthalmol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1007\/s10792-020-01316-5","article-title":"The prevalence of refractive errors in the Middle East: a systematic review and meta-analysis","volume":"40","author":"Khoshhal","year":"2020","journal-title":"Int Ophthalmol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0000000000000516","article-title":"The age-specific prevalence of myopia in Asia: a meta-analysis","volume":"92","author":"Pan","year":"2015","journal-title":"Optom Vis Sci"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1080\/09286580490514513","article-title":"The age- and gender-specific prevalences of refractive errors in Tehran: the Tehran Eye Study","volume":"11","author":"Hashemi","year":"2004","journal-title":"Ophthalmic Epidemiol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.optom.2024.100534","article-title":"Prevalence of refractive errors among school students in Iraq \u2014 a systematic review and meta-analysis","volume":"18","author":"Aljaberi","year":"2025","journal-title":"J Optom"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.31185\/jwsm.402","article-title":"Prevalence of refractive errors and eye disorders among primary school children in Al-Kut City, Wasit Governorate, Iraq","volume":"7","author":"Hussien Adnan Hussien","year":"2014","journal-title":"J Wasit Sci Med"},{"key":"B25","doi-asserted-by":"publisher","first-page":"68","DOI":"10.36346\/sarjams.2025.v07i03.001","article-title":"Prevalence of refractive errors among secondary-school students in Baghdad City","volume":"7","author":"Obeed","year":"2025","journal-title":"South Asian Res J Appl Med Sci"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.5455\/rmj.20230305073651","article-title":"Prevalence of refractive errors among primary school students in Mosul City, Iraq","volume":"48","author":"Hassan","year":"2023","journal-title":"Rawal Med J"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0349697","article-title":"Distribution of refractive errors and horizontal concomitant strabismus in Iraqi children","volume":"21","author":"Aljaberi","year":"2026","journal-title":"PLoS One"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1080\/08164622.2025.2537220","article-title":"Comparative analysis of cycloplegic and non-cycloplegic refraction techniques for assessing refractive error in adults: a population-based study","volume":"109","author":"Hashemi","year":"2025","journal-title":"Clin Exp Optom"},{"key":"B29","unstructured":"Eye care, vision impairment and blindness: refractive errors\n          \n          2024"},{"key":"B30","doi-asserted-by":"publisher","first-page":"M20","DOI":"10.1167\/iovs.18-25957","article-title":"Defining and classifying myopia report IMI","volume":"60","author":"Jong","year":"2019","journal-title":"Int Myopia Inst"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.4236\/ojoph.2024.143030","article-title":"Prevalence and factors associated with refractive errors among university students at Mbarara University of Science and Technology, Uganda","volume":"14","author":"Kamara","year":"2024","journal-title":"Open J Ophthalmol"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60272-4","article-title":"Myopia","volume":"379","author":"Morgan","year":"2012","journal-title":"Lancet"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1080\/09286586.2024.2354700","article-title":"Association between near work, physical activities and myopia in Korean adults during COVID-19 outbreak","volume":"32","author":"Han","year":"2025","journal-title":"Ophthalmic Epidemiol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1146\/annurev-vision-091718-015027","article-title":"Origins of refractive errors: environmental and genetic factors","volume":"5","author":"Harb","year":"2019","journal-title":"Annu Rev Vis Sci"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.56216","article-title":"Systematic review of sleep duration and development of myopia","volume":"16","author":"Chawla","year":"2024","journal-title":"Cureus"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1111\/ceo.14277","article-title":"Association between sleep duration, sleep quality, bedtime and myopia: a systematic review and meta-analysis","volume":"51","author":"Wang","year":"2023","journal-title":"Clin Exp Ophthalmol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.4103\/ijo.IJO_1564_21","article-title":"Physical activity, time spent outdoors, and near work in relation to myopia prevalence, incidence, and progression: an overview of systematic reviews and meta-analyses","volume":"70","author":"Karthikeyan","year":"2022","journal-title":"Indian J Ophthalmol"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1186\/s40101-024-00354-7","article-title":"The influence of the environment and lifestyle on myopia","volume":"43","author":"Biswas","year":"2024","journal-title":"J Physiol Anthropol"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0337335","article-title":"Prevalence of dry eye symptoms and associated risk factors among students at Al-Mustaqbal University, Iraq","volume":"20","author":"Aljaberi","year":"2025","journal-title":"PLoS One"},{"key":"B40","article-title":"Parental myopia, near work, school achievement, and children\u2019s refractive error","volume":"43","author":"D.O.","year":"2002","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-019-00512-7","article-title":"Interaction between lifestyle and genetic susceptibility in myopia: the Generation R study","volume":"34","author":"Enthoven","year":"2019","journal-title":"Eur J Epidemiol"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.11-9091","article-title":"Time outdoors and physical activity as predictors of incident myopia in childhood: a prospective cohort study","volume":"53","author":"Guggenheim","year":"2012","journal-title":"Investig Ophthalmol Vis Sci"},{"key":"B43","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1111\/opo.12009","article-title":"Statistical guidelines for the analysis of data obtained from one or both eyes","volume":"33","author":"Armstrong","year":"2013","journal-title":"Ophthalmic Physiol Opt"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1016\/j.clae.2025.102441","article-title":"Effect of soft contact lens wear on corneal endothelial cell characteristics","volume":"48","author":"Aljaberi","year":"2025","journal-title":"Contact Lens Anterior Eye"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.3389\/fopht.2026.1787176","article-title":"Comparative clinical outcomes of SMILE, femtosecond LASIK, and transepithelial PRK: a multicenter Iraqi study","volume":"6","author":"Aljaberi","year":"2026","journal-title":"Front Ophthalmol"}],"container-title":["Frontiers in Ophthalmology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fopht.2026.1904325\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:44:42Z","timestamp":1790574282000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fopht.2026.1904325\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":45,"alternative-id":["10.3389\/fopht.2026.1904325"],"URL":"https:\/\/doi.org\/10.3389\/fopht.2026.1904325","relation":{},"ISSN":["2674-0826"],"issn-type":[{"value":"2674-0826","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]},"article-number":"1904325"}}