INTERNATIONAL JOURNAL OF RESEARCH AND INNOVATION IN SOCIAL SCIENCE (IJRISS)  
ISSN No. 2454-6186 | DOI: 10.47772/IJRISS | Volume IX Issue XI November 2025  
Prevalence of Myopia in Medical students of Sialkot, Pakistan  
*Dr. Amjad Iqbal Burq1, Maheen Ashfaq2, Nihaal Fatima2, Sania Bibi2  
1Associate Professor, Department of Community Medicine, Islam Medical College, Sialkot, Pakistan  
2Department of Community Medicine, Islam Medical College, Sialkot, Pakistan (MBBS Student, Final  
Year)  
*Corresponding Author  
DOI: https://doi.org/10.47772/IJRISS.2025.91100650  
Received: 07 December 2025; Accepted: 16 December 2025; Published: 29 December 2025  
ABSTRACT  
Background: Myopia is a rapidly increasing refractive error worldwide, particularly affecting young adults  
engaged in intensive near-work. Medical students are considered a high-risk group due to prolonged study hours,  
high screen exposure, and limited outdoor activity.  
Objective: To assess the prevalence, risk factors, symptoms, and awareness of myopia among undergraduate  
medical students in Sialkot.  
Material and Methods: A cross-sectional study was conducted from August to September, 2025 at Islam  
Medical College, Sialkot Medical College, and Khawaja Muhammad Safdar Medical College. A total of 201  
students from MBBS, BDS, DPharm, and DPT programs were selected using random sampling method. Data  
was collected through a structured questionnaire covering demographics, myopia status, symptoms, family  
history, screen time, outdoor activity, and awareness of preventive measures. Data was analyzed using SPSS  
version 29.  
Results: Out of 201 participants, 64.7% were female, and most (59.8%) were aged 20–23 years. The prevalence  
of self-reported myopia was 53.2%, with 51.2% using eyeglasses as the primary correction method. Common  
symptoms included headaches (42.8%) and blurred distance vision (41.3%). Nearly half (49.8%) reported a  
family history of myopia, and 36.8% had daily screen exposure of 7–8 hours. Reading (49.8%) and mobile use  
(37.8%) were the most affected daily activities, while 42.3% reported a negative impact on academic  
performance. Although 75.1% were aware of screen time as a risk factor and 76.1% knew about preventive  
methods, only 46.3% practiced screen-time reduction, and most reported limited success.  
Conclusion: Myopia prevalence among medical students in Sialkot is high, with significant visual and academic  
impacts. Family history, excessive screen exposure, and reduced outdoor activity were key contributors. Despite  
awareness, preventive practices remain underutilized, underscoring the need for targeted educational and  
lifestyle interventions.  
Keywords: Myopia, Medical students, Prevalence, Risk factors, Screen time  
INTRODUCTION  
In simple terms, myopia is a refractive error that causes impairment in the person’s visual ability to see objects  
from a distance. It is more prevalent in developed and industrial areas and occurs in all age groups [1]. In recent  
years myopia has been growing in staggering numbers, with a recent study claiming that without prompt  
intervention, myopia will show a significant increase globally, affecting nearly 5 billion people worldwide [2].  
More time spent on work that requires near vision and less outdoor activities as well as high level of education  
are very common factors that contribute to the development and prevalence of myopia in the general population  
[3].  
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Recent studies have shown that a higher intelligence and school work which students have to undertake leads to  
early development of myopia [4], bringing us to the conclusion that medical students are more prone to such a  
refractive error due to the nature of their studies. Across regions, medical students consistently show a higher  
proneness to myopia compared with age-matched fellows, likely reflecting a blend of genetic susceptibility and  
intense, prolonged near-work demands and poor health and lifestyle: reading, screens, busy schedules, typical  
of medical studies and training [5]. Reported prevalence in medical students commonly ranges from the high 30s  
to >70% [6], with East/Southeast Asian settings belonging to the upper end of that spectrum[7].  
These findings propose that medical education may hasten both the development and progression of myopia. In  
addition to visual burden, uncorrected or progressive myopia can adversely impact quality of life, academic  
performance, and mental health, highlighting the importance of early detection and preventive strategies in this  
exposed population[8]. Understanding the prevalence and contributing factors as well as risk factors of myopia  
in medical students is therefore critical for developing targeted interventions and preventive strategies, both at  
the personal and institutional levels.  
Medical students often exhibit high myopia prevalence due to intense near-work demands and limited outdoor  
exposure, consistent with environmental and genetic risk patterns widely recognized in the global myopia  
literature [9].  
Abdul Malik et al. conducted a cross-sectional study of 110 medical students, from September to October in the  
year 2020, in Lahore, Pakistan [10]. 83.6% were myopic: primarily moderate to high myopia and only ~30%  
took outdoor breaks; ~54% had a family history.  
Berhane et al. found a much lower prevalence of 16.7%, using objective refractive examinations [11].  
Independent risk factors included urban residence, family history, >5–8 h/day work involving near vision, and  
<3 h/week outdoor activity or time spent in daylight.  
Alqudah et al. conducted a study upon 700 students and reported 75% had refractive errors, with myopia being  
most common; 79% had a positive family history [12]. The study grouped refractive errors together, writing  
myopia as most common, but without separate detailed analysis. The study only highlighted simple associations  
with myopia or other refractive errors, making the risk analysis descriptive rather than multi-variate.  
In a study conducted by Rathore et al. at Army Medical College, Rawalpindi, with a sample size of 300 students,  
the results yielded that 50% had myopia [13], with familial aggregation. Yet only 21% of students recognized  
risk factors like increased screen time or use of poor lighting.  
A study conducted in 2023 by Oszczędłowski et al., concluded myopia in 27.2% of medical students and  
analyzed demographic/behavioral correlates [5]. The study had several limitations. Its cross-sectional design  
impedes any assessment of incidence or causality. Cycloplegia was not used, which may have led to imprecise  
measurement of refractive error. The sample consisted majority of European White medical students, which  
limits the external legitimacy of the findings to populations in regions with higher myopia prevalence. In  
addition, the study did not prospectively track adult-onset myopia or changes in axial length over time. The  
authors themselves highlighted the need for prospective cohort studies to explain the incidence and progression  
of adult-onset myopia during medical training.  
Adescriptive cross-sectional study of 279 medical undergraduates in Nepal reported a relatively high prevalence  
of myopia at 42.65% [14]. While the findings emphasize a significant visual health burden in this population,  
several limitations were existing. The study employed convenience sampling within a single institution, which  
lessens generalizability. It also relied on non-cycloplegic assessments and self-reported spectacle use, which  
could result in missed cases of mild or undiagnosed myopia. Furthermore, the study did not explore behavioral  
risk factors in depth, such as screen exposure, lighting conditions, or hours of near-work, which are highly  
appropriate in student populations. The analysis also did not stratify prevalence by year of study or by phase of  
medical training, which could have revealed trends in adult-onset or progression of myopia during medical  
education and training. These omissions represent important gaps for future researches.  
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A study conducted across various colleges in Bahrain [15], including medical students, reported that nearly one  
in two partakers had myopia. The research also showed that parental history of myopia was common among  
affected people. However, the study design had several limitations. It included students from multiple health-  
related disciplines, making it difficult to extract results particular to medical students. The study was also cross-  
sectional and relied on non-cycloplegic methods, which may lessen the accuracy of prevalence estimates. In  
addition, the assessment of risk factors was descriptive and not adjusted for potential factors, such as academic  
workload, outdoor time, or year of study. These limitations suggest the need for medical-student-specific  
analyses in future Bahraini or Gulf regional studies.  
A recent cross-sectional study in Andhra Pradesh, India, reported a myopia prevalence of 61.6% among medical  
students [16], making it one of the highest estimates within the last five years. The study also highlighted  
significant associations with demographic and behavioral risk factors. Despite these strengths, the study was  
conducted in a single state, and its findings may not represent the diverse Indian medical student population.  
Like most previous studies, cycloplegia was not employed, which could result in misclassification of refractive  
error. Its cross-sectional design excluded analysis of incidence or progression across medical school years.  
Moreover, although it was conducted during the post-pandemic period, the study did not specifically examine  
how increased smartphone use or online classes added to myopia progression. The lack of stratification by  
severity also meant that the burden of high myopia was not investigated. These gaps stress the need for  
prospective, multicenter studies that track medical students longitudinally with standardized refraction and axial  
length measurement.  
Grigore T. Popa University of Medicine and Pharmacy in Romania conducted a large questionnaire-based study  
[17] involving 576 medical students and found myopia prevalence of 73.8%. Interestingly, the data showed that  
43.8% of sixth-year students already had myopia at admission, compared to 64% in first-year students,  
suggesting that the onset of myopia is shifting to earlier and younger ages. While this study underscores an  
alarming upward trend, it is limited by its reliance on self-reported refractive status rather than clinical  
examination, which may have led to recall bias. Additionally, it did not explore environmental risk factors such  
as screen exposure or time spent outdoors, creating a gap for future research.  
In Southern Rajasthan, India, a study[18] among 150 first-year MBBS students reported a prevalence of 62.7%,  
with female students significantly more affected than males (p < 0.005). Most cases were classified as low  
myopia (75%), while moderate to high myopia reported to be 20.2% and 7.4%, respectively. The authors credited  
much of this burden to near-work activity. However, the study’s small sample size and limitation to a single  
academic year bounds the generalizability of its findings. Additionally, it did not examine the role of family  
history or urbanization, which are known contributive factors.  
A cross-sectional study in Jalandhar, Punjab, India, that included 590 medical students found a myopia  
prevalence of 70.3%. The analysis showed a statistically significant association with family history (p = 0.003),  
while other factors such as screen time, reading distance, and sleep duration did not achieve statistical  
significance. Although the relatively large sample size reinforces its conclusions, the study relied on self-reported  
data for lifestyle behaviors, which may have introduced recall bias. Moreover, its focus on a single institution  
reduces external validity, and the absence of longitudinal data limits causal inferences [19].  
METHODOLOGY  
This descriptive, cross-sectional, epidemiological study was conducted fromAugust to September 2025 at Islam  
Medical College, Sialkot Medical College, and Khawaja Muhammad Safdar Medical College, Sialkot. A total  
of 201 undergraduate medical students were enrolled using a random sampling technique. Both male and female  
students from MBBS, BDS, DPharm, and DPT programs who provided informed consent were encompassed,  
while those unwilling to participate were excluded. Data was collected using a structured, pretested, and  
authenticated questionnaire designed to assess the prevalence of myopia and associated factors. The  
questionnaire covered sociodemographic details, vision-related symptoms, family history, screen exposure,  
outdoor activities, awareness of risk factors, preventive exercises, and the influence of vision problems on  
academic and daily life. The dependent variable was the presence of myopia, whereas independent variables  
included age, gender, academic year, family history, and screen time. Questionnaires were administered in person  
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within the respective institutions to ensure precision and completeness. Data was coded and entered into SPSS  
version 29 for analysis. Descriptive statistics such as frequencies and percentages were applied to summarize  
demographic characteristics, distribution of refractive errors, related symptoms, vision correction methods, and  
awareness levels.  
RESULTS  
Table 1 shows the sociodemographic characteristics of the participants. A total of 201 medical students  
participated in the study. The majority of respondents were female (64.7%), while 35.3% were male. Most  
students were in the 20–23 year age group (59.8%), with smaller proportions in the 18–19 year group (24.4%)  
and the 24–25 year group (15.9%). Participants were fairly evenly distributed across academic disciplines, with  
MBBS (26.9%), BDS (25.9%), DPharm (24.9%), and DPT (22.4%).  
Table 1. Distribution of study participants by sex, age, and academic course (n = 201)  
Frequency  
Percentage  
35.3%  
64.7%  
24.4%  
29.9%  
29.9%  
15.9%  
26.9%  
25.9%  
24.9%  
22.4%  
Sex  
Age  
Male  
71  
130  
49  
60  
60  
32  
54  
52  
50  
45  
Female  
years (18-19)  
Years (20-21)  
Years (22-23)  
Years (24-25)  
MBBS  
Course Name  
BDS  
DPharm  
DPT  
Table 2 presents the vision-related symptoms and impacts reported by participants. Headaches (42.8%) and  
blurred vision at a distance (41.3%) were the most commonly experienced symptoms, followed by eye strain or  
fatigue (10%). More than half of the students (53.2%) reported having been diagnosed with myopia, and the  
majority (79.1%) had normal vision after correction (Figure 1). Eyeglasses were the most frequently used  
corrective method (51.2%), while (39.8%) reported no current vision correction. Over half (53.2%) indicated  
that their myopia had not progressed, whereas (21.9%) and (17.9%) reported slow or moderate progression,  
respectively. Reading (49.8%) and mobile phone use (37.8%) were the daily activities most affected by vision  
difficulties, and (42.3%) of students stated that their vision problems negatively influenced their academic  
performance.  
Table 2. Frequency and percentage distribution of vision-related factors and myopia characteristics among  
students  
Frequency  
Percentage  
41.3%  
Related Symptoms to vision  
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Blurred vision at a distance  
Headaches  
83  
86  
42.8%  
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Eyes strain or fatigue  
Double vision  
difficulty seeing at night  
hours (1-2)  
hours (3-4)  
hours (5-6)  
hours (7-8)  
Yes  
20  
6
10.0%  
3.0%  
6
3.0%  
Screen time in a day  
24  
48  
55  
74  
107  
92  
2
11.9%  
23.9%  
27.4%  
36.8%  
53.2%  
45.8%  
1.0%  
Ever Diagnosed with Myopia  
No  
Don't know  
others  
0
0.0%  
Vision after correction  
Normal Vision  
Myopia  
159  
40  
2
79.1%  
19.9%  
1.0%  
Hyperopia  
Astigmatism  
Eyeglasses  
0
0.0%  
Current vision correction  
Myopia progressed overtime  
Recent visit to ophthalmologist  
103  
14  
4
51.2%  
7.0%  
Contact lenses  
Refractive Surgery (LASIK)  
None  
2.0%  
80  
44  
36  
14  
107  
24  
62  
47  
68  
76  
39.8%  
21.9%  
17.9%  
7.0%  
Slow  
Moderately  
Rapidly  
Not progressed  
1 month ago  
6 months ago  
12 months ago  
24 months ago  
Using mobile  
53.2%  
11.9%  
30.8%  
23.4%  
33.8%  
37.8%  
Vision affects daily activity  
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Patients’ examination  
6
3.0%  
Driving  
19  
100  
85  
84  
32  
0
9.5%  
Reading  
49.8%  
42.3%  
41.8%  
15.9%  
0.0%  
Effect on academic performance  
Yes  
No  
Not sure  
Don't want to mention  
Figure 1. Distribution of vision status after correction among study participants  
Table 3 outlines student’s awareness and practices related to eye care. Nearly half of the respondents (50.7%)  
reported visiting an ophthalmologist only when experiencing vision-related problems, while 32.8% attended  
annual check-ups. Social media, particularly Instagram (53.7%) and YouTube (33.3%), was the most common  
source of information. A large proportion of participants agreed or strongly agreed that medical students are  
more prone to myopia (78.6%), and nearly half (49.8%) reported a family history of the condition. Awareness of  
screen time as a risk factor was high (75.1%), and most students (76.1%) were also aware of preventive methods.  
Reducing screen time (46.3%) was the most commonly practiced prevention strategy, although (52.7%) reported  
only limited success in doing so.  
Table 3. Distribution of participants according to ophthalmic visit frequency, awareness, and preventive  
practices related to myopia (n = 201)  
Frequency  
Percentage  
32.8%  
Frequency  
ophthalmologist  
of  
visit  
to Annually  
Biannually  
66  
6
3.0%  
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At the time of changing glasses  
Having problem with vision  
YouTube  
27  
102  
67  
10  
108  
16  
70  
88  
21  
22  
100  
91  
8
13.4%  
50.7%  
33.3%  
5.0%  
Information from social media  
Medical students prone to myopia  
Family history  
Facebook  
Instagram  
53.7%  
8.0%  
X.com  
Strongly agree  
Agree  
34.8%  
43.8%  
10.4%  
10.9%  
49.8%  
45.3%  
4.0%  
Neutral  
Disagree  
Yes  
No  
Don't know  
Don't want to mention  
less than 30 minutes  
30-60 minutes  
1-2 hours  
2
1.0%  
Hours in Daylight  
25  
54  
66  
56  
151  
40  
4
12.4%  
26.9%  
32.8%  
27.9%  
75.1%  
19.9%  
2.0%  
More than 2 hours  
Yes, very aware  
Somewhat aware  
Heard about it but not sure  
Not aware at all  
Yes  
Awareness of screentime as risk  
6
3.0%  
Aware of prevention Methods  
Methods of prevention followed  
153  
48  
46  
18  
93  
10  
76.1%  
23.9%  
22.9%  
9.0%  
No  
20-20-20 rule (eye rest every 20 minutes)  
Outdoor activities  
Reduce screentime  
use of atropine drops or Otho-k lenses  
46.3%  
5.0%  
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others  
34  
44  
106  
29  
22  
16.9%  
21.9%  
52.7%  
14.4%  
10.9%  
Tried to reduce screentime  
Yes, successfully reduced  
Yes, but with little success  
No, but I plan to try  
No, and I do not plan to  
DISCUSSION  
Our study aimed to evaluate the prevalence of myopia among 201 medical students along with their visual health  
practices & associated demographic and behavioral factors. This study revealed several remarkable findings: a  
high prevalence of myopia (53.2%) prevalent symptoms such as headaches (42.8%) and distance blurred vision  
(41.3%), extensive daily screen time (majority engaging 5-8 hours) & high levels of awareness of risk factors  
(75.1%), albeit with limited success in behavior change (only 21.9% successively reduced screen time). These  
insights align with global patterns and offer important information.  
With over half of participants diagnosed with myopia, our findings are congruent with studies from Lebanon  
(52.8%) [6], and Saudi Arabia (57.3%) [20]. Such consistency emphasizes that medical students-who often  
engage in prolonged near work-form a high-risk group regardless of geography and culture.  
Family History: Nearly half of participants (49.8%) reported a hereditary predisposition -a pattern echoed in  
multiple studies. In Lebanon, having myopic siblings significantly elevated myopia risk; in Saudi samples, those  
with one or two myopic parents had up to triple the risk [6].  
Near Work and Screen Time: The extensive screen usage (5-8 hours daily) resonates with dose-response meta-  
analysis findings showing that each additional hour of daily screen time raises myopia odds by 21%, and risk  
increases markedly up to 4 hours per day [21].  
Similarly, Lebanese medical trainees' data highlighted near-work, including reading or screen time, as  
independently increasing myopia risk [6].  
Myopic status was stable during the University period. Genetic factors play a major role in myopia. Protective  
measures are useful for university students [22].  
During the course of the 20th century, myopia among teenagers and adults in Finland [23] significantly increased  
and the mean change in refraction was towards myopia. Increased education is proposed as the main reason  
behind these changes while our study shows the same. Gender is associated with prevalence of myopia among  
polish school children ranging from 9 to 16 years of age [24] while our study also shows that myopia is prevalent  
with gender as well, the female to male ratio being higher among the results. The recent findings revealed that  
myopia predominated among schoolchildren in Weifang [25]. It steadily grew through age while our study does  
not signify the prevalence of myopia with age.  
Our respondents reported extensive daily screen time, with nearly two-thirds spending 5-8 hours per day on  
screens. This fits together with meta-analyses showing that each additional hour of daily screen time increases  
odds of myopia by approximately 21%, especially notable between 1 and 4 hours per day PMC [21].  
While awareness was high-75.1% recognized screen time as a risk, and 76.1% admitted preventive methods-  
only 21.9% successfully reduced their screen time, with 52.7% reporting limited success. This gap between  
awareness and action underscores the challenges of modifying engrained habits in a challenging academic  
environment. It suggests the need for structured interventions, such as institutional policies promoting regular  
breaks (e.g., the 20-20-20 rule), and environmental facilitators to encourage manageable behavior change.  
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CONCLUSION  
Across these studies, there is consistent evidence that medical students represent a high-risk group for myopia,  
primarily due to exhaustive academic demands and reduced outdoor exposure. However, significant gaps and  
limitations remain: early studies lacked detailed behavioral assessments, large-scale global projections excluded  
subgroup analyses, and more recent reviews focused more on treatment than prevalence. Even the most current  
research is limited by its restricted context. Future studies should adopt multicentric designs with diverse student  
populaces, include objective behavioral tracking, and incorporate management strategies with epidemiological  
findings to better address the growing burden of myopia among medical students.  
Conflict of interest: The study has no conflict of interest to declare by any author.  
Source of funding:  
None  
Ethical approval:  
The study was approved by the Institutional Review Board of Islam, Medical College,  
Sialkot, Pakistan.  
Authors’ contribution: Methodology, data collection, analysis, manuscript writing: All authors,  
Final approval: All authors  
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