Incidence and Risk Factors of Refractive Error in Children in Spain: CISViT Project.

Incidence and Risk Factors of Refractive Error in Children in Spain: CISViT Project. | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Incidence and Risk Factors of Refractive Error in Children in Spain: CISViT Project. Alba Galdón, Laura Guisasola, Mariam El Gharbi, Valldeflors Vinuela-Navarro, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7581469/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background: The incidence of refractive errors (RE), particularly myopia, has increased in recent years, presenting significant geographic variations. This prospective longitudinal cohort study aims to assess the incidence of RE in school-aged children in Spain and identify associated risk factors. Methods: The study followed 1,189 children with a one-year interval (mean age: 8.74 years at initial visit and 10.00 years at follow-up) in northeast Spain (2021–2024). RE was measured using an autorefractometer and retinoscopy without cycloplegia. A preliminary questionnaire collected data on risk factors such as visual habits and socioeconomic status. Results: The spherical equivalent (SE) at the initial visit was +0.29 ± 0.03D, decreasing to +0.14 ± 0.04D at follow-up. The prevalence of myopia increased from 12.3% at baseline to 17.1% at follow-up. Fifty-six incident cases were identified, corresponding to a cumulative incidence of 4.8%. Myopic progression, defined as a change in SE greater than −0.50 diopters, was observed in 24.6% of children; among them, 10.0% exhibited mild progression, 10.6% moderate, and 4.0% severe. Factors associated with myopia progression included paternal unemployment (OR = 1.479, p = 0.005), maternal unemployment (OR = 2.260, p = 0.015), low outdoor exposure (OR = 1.964, p < 0.001), and older age (OR = 1.256, p < 0.001). Conclusions : The incidence and progression of myopia in Spanish schoolchildren increased noticeably over one year. Older age, reduced outdoor time, and both paternal and maternal unemployment were associated with higher risk of myopic progression. Myopia Myopia risk factors Refractive error children Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 01 Dec, 2025 Reviews received at journal 01 Dec, 2025 Reviewers agreed at journal 30 Nov, 2025 Reviews received at journal 06 Oct, 2025 Reviewers agreed at journal 15 Sep, 2025 Reviewers invited by journal 11 Sep, 2025 Editor assigned by journal 11 Sep, 2025 Submission checks completed at journal 11 Sep, 2025 First submitted to journal 10 Sep, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7581469","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":515588650,"identity":"ab2dc844-e000-4c9c-9bde-81e56c8566dc","order_by":0,"name":"Alba 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Optics","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Myopia, Myopia risk factors, Refractive error, children","lastPublishedDoi":"10.21203/rs.3.rs-7581469/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7581469/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e\u003c/em\u003e The incidence of refractive errors (RE), particularly myopia, has increased in recent years, presenting significant geographic variations. This prospective longitudinal cohort study aims to assess the incidence of RE in school-aged children in Spain and identify associated risk factors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e The study followed 1,189 children with a one-year interval (mean age: 8.74 years at initial visit and 10.00 years at follow-up) in northeast Spain (2021–2024). RE was measured using an autorefractometer and retinoscopy without cycloplegia. A preliminary questionnaire collected data on risk factors such as visual habits and socioeconomic status.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eResults:\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e \u003c/em\u003eThe spherical equivalent (SE) at the initial visit was +0.29 ± 0.03D, decreasing to +0.14 ± 0.04D at follow-up. The prevalence of myopia increased from 12.3% at baseline to 17.1% at follow-up. Fifty-six incident cases were identified, corresponding to a cumulative incidence of 4.8%. Myopic progression, defined as a change in SE greater than −0.50 diopters, was observed in 24.6% of children; among them, 10.0% exhibited mild progression, 10.6% moderate, and 4.0% severe. Factors associated with myopia progression included paternal unemployment (OR = 1.479, p = 0.005), maternal unemployment (OR = 2.260, p = 0.015), low outdoor exposure (OR = 1.964, p \u0026lt; 0.001), and older age (OR = 1.256, p \u0026lt; 0.001).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/em\u003e\u003cstrong\u003e: \u003c/strong\u003eThe incidence and progression of myopia in Spanish schoolchildren increased noticeably over one year. Older age, reduced outdoor time, and both paternal and maternal unemployment were associated with higher risk of myopic progression.\u003c/p\u003e","manuscriptTitle":"Incidence and Risk Factors of Refractive Error in Children in Spain: CISViT Project.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-18 17:44:31","doi":"10.21203/rs.3.rs-7581469/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-01T19:20:30+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-01T06:56:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"167365562515323643610026602566820823456","date":"2025-11-30T11:52:39+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-07T03:32:59+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"97112562046997927221117235319865624781","date":"2025-09-16T00:28:08+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-11T11:45:15+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-11T11:41:24+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-11T07:01:16+00:00","index":"","fulltext":""},{"type":"submitted","content":"Ophthalmic and Physiological Optics","date":"2025-09-10T09:46:25+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"ophthalmic-and-physiological-optics","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Ophthalmic and Physiological Optics](https://link.springer.com/journal/44402)","snPcode":"44402","submissionUrl":"https://submission.springernature.com/new-submission/44402/3?","title":"Ophthalmic and Physiological Optics","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a5ef4790-462a-49a6-a2dd-45c5a47233bd","owner":[],"postedDate":"September 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-09T13:41:16+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-18 17:44:31","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7581469","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7581469","identity":"rs-7581469","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}