Prevalence and Patterns of Refractive Errors Among Nubian and Non-Nubian Adults in South Egypt

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Abdelrheem, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6858366/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 09 Sep, 2025 Read the published version in Discover Public Health → Version 1 posted 13 You are reading this latest preprint version Abstract Background: Refractive errors are regarded as a public health challenge; being the most common eye condition resulting from discrepancies in the cornea, lens, and axial length of the eye's focusing power and affecting all age groups. Refractive error is the leading cause of vision impairment contributing to 123.7 million cases of moderate to severe distance vision impairment or blindness. Intricate interactions between genetic and lifestyle factors result in refractive errors. Prevalence, pattern and degree of refractive errors were proved by many studies to be affected by racial and ethnic variations. Nubians differ culturally and ethnically from other Egyptians. Nubians are an ethnic group indigenous to the region which is now northern Sudan and southern Egypt. Purpose: The present study aims to detect the prevalence and patterns of different refractive errors among Nubian and non- Nubian adults in South Egypt. Methods: A community-based cross-sectional study that was carried out in randomly selected Nubian and non-Nubian districts. The study included 1820 adult individuals. They were divided into two groups (910 persons each) representing Nubian and non-Nubians adults in south Egypt. Following standard ophthalmic examination, autorefraction under mydriatics was done. Data was collected and tabulated Results: Overall prevalence of refractive errors was 63.4% among South Egyptian. Refractive Errors were found in 66.5% of Nubians and in 60.2% of non- Nubians. Astigmatism existed in 56.3% of patients with no significant difference between both groups. Nubians were significantly more hyperopic and less myopic than non-Nubians (p<0.001). Amblyopia was presented in 4.3% of participants and anisometropia in 3.7% which was significantly higher in non- Nubians (p =0.002). Conclusion: Nubians exhibit a higher prevalence of overall refractive errors compared to the non- Nubians, with a marked tendency towards hyperopia. Refractive errors Nubian hyperopia myopia South Egypt Figures Figure 1 1. Introduction Refractive errors (RE) are common optical aberrations caused by mismatching in the cornea, lens and axial length of the eye focusing power [1] . Refractive error can be classified into myopia (short or near-sightedness’), hyperopia (long or far-sightedness’) and astigmatism. In myopia there is excessive refraction at the cornea or lens, or more frequently, an elongated eye (called "axial myopia"), causes light to focus on a point anterior to the retina. In hyperopia, the reverse occurs with an image forming posterior to the retinal plane as a result of either inadequate refraction or a short axial length. In astigmatism, the refractive power of the eye is uneven across different meridians [2] . Despite efforts towards reducing the visual impairment caused by RE, the prevalence of visual impairment is still rising [3] . Globally, uncorrected RE leads to diminished quality of life for millions regardless of age, gender, or ethnicity. Uncorrected RE has significant social and economic consequences, including the restriction of educational and employment opportunities for economically active individuals, the aesthetic appearance, personal health and safety, challenges in daily activities, and various inconveniences in everyday life [4] . Early identification of vision issues can improve one's quality of life, conduct and education [5]. Global programs prioritize the correction of refractive problems and poor vision [6] . Nubians are an ethnic group indigenous to the region which is now northern Sudan and southern Egypt. They originate from the early inhabitants of the central Nile valley, believed to be one of the earliest cradles of civilization. In the southern valley of Egypt, Nubians differ culturally and ethnically from other Egyptians, they speak Nubian languages as a mother tongue, part of the Northern Eastern Sudanic languages, and Arabic as a second language [7] . Up to our knowledge, the prevalence of RE among adults remains insufficiently documented in certain regions of Egypt, particularly in Upper Egypt. Notably, there is a lack of comprehensive data regarding the prevalence of RE among Nubian populations. This highlights the critical need for assessing the prevalence, types, and extent of RE among Nubians, as well as other inhabitants of southern (Upper) Egypt. 2. Research Methods This is a community-based cross-sectional study that was carried out in a randomly selected Nubian and non-Nubian districts. Nubians in Egypt primarily live in south Egypt, especially in Komombo and Naser alnuba. Their population is around 600,000 representing roughly one percent of Egypt's population according to Central Agency for Public Mobilization and Statistics [8] . Data collection was conducted from July 2023 to November 2024. A total of 1,820 participants (3,640 eyes) aged 18–40 years were examined, equally divided into Nubian (n = 910) and non-Nubian (n = 910) groups. Districts were randomly selected from Nubian and non-Nubian areas to ensure representation of the sample. All attendees accepted to participate in the study first undertook visual acuity test using tumbling E chart. Patients were selected by the interval random sampling. This screening program included Nubian and non-Nubian districts that have been randomly selected. Moreover, all Nubians and non -Nubians between ages of 18 and 40 years living in these districts were examined and included in the study. However, Individuals who had eye surgery, manifest strabismus, or previous history of injuries in the eye were excluded from the study. The examinations have been performed in temporary camp by a study team that included one coordinator, one ophthalmologist, two ophthalmic nurses, and one biostatistician. Standard ophthalmic examination procedure had been used for each study subject and recorded in RE assessment information sheet. Ophthalmic examination included assessment of visual acuity for distance with Snellen’s illiterate ‘E’ chart at room illumination and ocular motility evaluation. The distant vision had been tested with the chart at 6 meters and then participants further investigated by refraction under mydriatics. Mydriatic refraction had been used to determine refractive errors of these target population in this study. Pupils dilated with two drops of 1% tropicamide eye drops, administered three times 5 minutes apart. After 45 minutes, light reflex and pupil dilation were evaluated. Both eyes were examined using the automatic refractometer (RM-800, Topcon, Tokyo, Japan). Slit lamp examination of the anterior segment, media and fundus was done. After completion of eye examination, everyone was given an examination report about his/her eye status. Cases with RE were given written eye examination reports and spectacles. Vision was assessed for recruited adult Nubians and non-Nubians; refraction was done by subjective and objective methods and appropriate spectacles were prescribed. Adult Nubians with no improvement by the above methods and those with other ocular morbidities will be referred to the nearest tertiary hospital for further evaluation and were excluded from the study. 2.1 Statistical analysis: Data were collected, revised, coded, and entered and analyzed using the Statistical Package for the Social Sciences (IBM SPSS, version 26; IBM, New York, USA). The prevalence of RE among the screened subjects was calculated. Qualitative data were presented as numbers and percentages, while quantitative data were expressed as mean and standard deviation (SD). A 95% confidence interval was applied, with a margin of error of 5%. A two-sided P value less than 0.05 was regarded as statistically significant for all analyses. 3. Ethical considerations The study was approved by the ethics committee of Aswan University Faculty of Medicine. informed consent was taken from all participants. 4. Results The present study included 1820 participants, equally divided between Non- Nubian and Nubian populations (910 each); Socio-demographic characteristics of both groups revealed that Nubians have significant female preponderance, higher rate of consanguinity, resident mostly in rural areas and have lower level of education compared to non-Nubian population (P < 0.001) (table 1). Table (1): Comparison of Socio-Demographic Characteristics between Non- Nubians and Nubian Adult Populations in South Egypt, 2023 Variables Non- Nubians (n = 910) No (%) Nubian (n = 910) No (%) P-value* Age (years) Mean ± SD (Range) 31.9 ± 6.8 32.7 ± 6.6 0.057 † Gender Male 532 (58.5) 401 (44.1) < 0.001 Female 378 (41.5) 509 (55.9) Residence Rural 397 (43.6) 516 (56.7) < 0.001 Urban 513 (56.4) 394 (43.3) Consanguinity No 868 (95.4) 333 (36.6) < 0.001 Yes 42 (4.6) 577 (63.4) Educational level Non-educated\ Read& write 68 (7.5) 119 (13.1) < 0.001 Basic education 29 (3.2) 48 (5.3) Secondary 244 (26.8) 367 (40.3) Above secondary 569 (62.5) 376 (41.3) Visual complain Absent 432 (47.5) 402 (44.2) 0.158 Present 478 (52.5) 508 (55.8) *Chi-square test; †Independent t-test; p-value < 0.05 is considered significant The overall prevalence of RE is 63.4% among South Egyptian inhabitants. The Nubian population exhibits a significantly higher prevalence of RE compared to non-Nubian population (66.5% and 60.2% respectively, p = 0.006). The overall prevalence of myopia was noted in 32.8% and hyperopia in 32.3% in south Egyptian population with significantly higher myopia but less hyperopia in non-Nubians compared to Nubian population (p < 0.001). Astigmatism existed in 56.3% of patients with no significant difference between both groups. Amblyopia was presented in 4.3% of participants with no significant difference between both groups (P = 0.165). However, anisometropia represents 3.7% which was significantly more prevalent in the non-Nubian group (5.1%) compared to the Nubian group (2.3%), with a P-value of 0.002, indicating a statistically significant difference (table 2, Fig. 1). Table (2): Comparison of refractive errors between Non- Nubians and Nubian Adult Populations in South Egypt Total n = 1820 (%) Non- Nubians n = 910 (%) Nubian n = 910 (%) P-value* Refractive errors 1154 (63.4) 548 (60.2) 606 (66.5) 0.006 Myopia (> -0.5 D) 596 (32.8) 438 (48.1) 158 (17.3) + 1 D) 587 (32.3) 125(13.7) 462 (50.9) < 0.001 Astigmatism (≥ 1D) 1024 (56.3) 518 (56.9) 506 (55.6) 0.571 Anisometropia 67 (3.7) 46 (5.1) 21 (2.3) 0.002 Amblyopia 78 (4.3) 45 (4.9) 33 (3.6) 0.165 *Chi-square test, p-value < 0.05 is significant As regards to mean spherical equivalent, significant difference with hyperopic shift was noted among Nubian population in both eyes (P < 0.001). Otherwise, significant myopic astigmatism was noted in right and left eyes of non-Nubians adults compared to that of Nubian participants (P = 0.004 and < 0.001 respectively) (table 3). Table (3): Comparison of spherical equivalent and astigmatism between Non- Nubians and Nubian adult populations in South Egypt, 2023 Eye status Non- Nubians (n = 910) Nubian (n = 910) P-value * Mean ± SD Spherical Equivalent Right eye -0.80 ± 0.09 0.91 ± 0.08 < 0.001 Left eye -0.61 ± 0.07 0.73 ± 0.07 < 0.001 Astigmatism Right eye -0.83 ± 0.04 -0.30 ± 0.05 0.004 Left eye -0.75 ± 0.05 -0.36 ± 0.05 < 0.001 Independent t-test; p-value < 0.05 is considered significant Regarding the comparison of refraction status in the right eye between the non-Nubian and Nubian populations, a significant difference was found (p < 0.001). While emmetropia rates were similar in both groups, hyperopia was significantly more prevalent in the Nubian population (40.9%) compared to non-Nubian (10.2%). Conversely, myopia was more common among the non-Nubians (41.9%) than in Nubian (12.3%). Also, the comparison of refraction status of left eye between non-Nubian and Nubian populations reveals significant differences (p < 0.001), with Nubians showing a higher prevalence of hyperopia (39.5% vs 9.6%) and non-Nubian residents exhibiting more myopia (45.5% vs 14.3% in Nubians). Emmetropia rates were similar in both groups. Astigmatism was found to affect about 56.3% of all participants with no significant difference in the prevalence between the Non- Nubians and Nubian adult populations (p = 0.571). Astigmatism was present in 56.9% of the non-Nubian group and 55.6% of the Nubian group, indicating similar patterns of this refractive error in both populations. In both eyes it was found that compound myopic astigmatism was more prevalent in the non-Nubian sample while mixed and compound hyperopic astigmatism was more common in the Nubian sample. (table 2,4) Table (4): Comparison of refraction status of the examined eyes between two studied groups Total (n = 1820) Non- Nubians (n = 910) Nubian (n = 910) P-value* Refraction status (Right eye) Emmetrope (+ 1 to -0.5 D) 862 (47.4) 436 (47.9) 426(46.8) + 1 D) 465 (25.5) 93 (10.2) 372(40.9) Myope (> -0.5 D) 493 (27.1) 381 (41.9) 112(12.3) Astigmatism status (≥ -1) (Right eye) No 1002(55.1) 499 (54.8) 503(55.3) < 0.001 Simple myopic astigmatism 22 (1.2) 16 (1.8) 6 (0.7) Compound myopic astigmatism 306 (16.8) 253 (27.8) 53 (5.8) Simple hyperopic astigmatism 36 (2.0) 12 (1.3) 24 (2.6) Compound hyperopic astigmatism 217 (11.9) 68 (7.5) 149(16.4) Mixed astigmatism 237 (13.0) 62 (6.8) 175(19.2) Refraction status (Left eye) Emmetrope (+ 1 to -0.5 D) 830 (45.6) 409 (44.9) 421(46.3) + 1 D) 446 (24.5) 87 (9.6) 359(39.5) Myope (> -0.5 D) 544 (29.9) 414 (45.5) 130(14.3) Astigmatism status (≥ -1) (Left eye) No 1056(58.0) 501(55.1) 555(61.0) < 0.001 Simple myopic astigmatism 13 (0.7) 9 (1.0) 4 (0.4) Compound myopic astigmatism 316 (17.4) 249 (27.4) 67 (7.4) Simple hyperopic astigmatism 40 (2.2) 18 (2.0) 22 (2.4) Compound hyperopic astigmatism 142 (7.8) 44 (4.8) 98 (10.8) Mixed astigmatism 253 (13.9) 89 (9.8) 164(18.0) *Chi-square test; p-value < 0.05 is considered significant Associations between refractive errors and various socio-demographic characteristics among the non-Nubians and Nubian adult populations were examined. Higher means of age seems to be significantly associated with RE among the non-Nubians. Moreover, a significant relationship between consanguinity and refractive error is observed in the Nubian group, where 61.0% of those with refractive errors report consanguinity (P = 0.033). However, no such significant difference is found in the non-Nubian population (P = 0.459). In the Nubian population, the educational level is significantly associated with refractive error prevalence (P = 0.005), indicating that higher educational attainment correlates with an increased prevalence of refractive errors. Conversely, this association is not statistically significant in the non-Nubian population (P = 0.074), suggesting that educational level does not have a substantial impact on refractive error prevalence in this group. Visual complaints are significantly more common among those with refractive errors in non-Nubians (70.1%) compared to those without (26.0%) (P < 0.001). However, In the Nubian group, the difference is not statistically significant (P = 0.699) (table 5). Table (5): Comparison of refractive errors by socio-demographic variables in Non- Nubians and Nubian adult populations in South Egypt, 2023 Studied Characteristics Non- Nubians (n = 910) Nubian (n = 910) Refractive error No. (%) Refractive error No. (%) Absent (n = 362) Present (n = 548) Absent (n = 305) Present (n = 605) Age (years) Mean ± SD 30.9 ± 7.1 32.6 ± 6.5 32.2 ± 6.7 33.0 ± 6.6 P-value ¥ < 0.001 0.107 Sex Male 222 (61.3) 310 (56.6) 141 (46.2) 260 (43.0) Female 140 (38.7) 238 (43.4) 164 (53.8) 345 (57.0) P-value* 0.154 0.351 Residence Rural 161 (44.5) 236 (43.1) 168 (55.1) 348 (57.5) Urban 201 (55.5) 312 (56.9) 137 (44.9) 257 (42.5) P-value* 0.674 0.483 Consanguinity No 343 (94.8) 525 (95.8) 97 (31.8) 236 (39.0) Yes 19 (5.2) 23 (4.2) 208 (68.2) 369 (61.0) P-value* 0.459 0.033 Educational level Non-educated\ Read& write 25 (6.9) 43 (7.8) 37 (12.1) 82 (13.6) Basic education 18 (5.0) 11 (2.0) 25 (8.2) 23 (3.8) Secondary education 91 (25.1) 153 (27.9) 106 (34.8) 261 (43.1) Above secondary 228 (63.0) 341 (62.2) 137 (44.9) 239 (39.5) P-value* 0.074 0.005 Visual complain Absent 268 (74.0) 164 (29.9) 132(43.3) 270 (44.6) Present 94 (26.0) 384 (70.1) 173 (56.7) 335 (55.4) P-value* < 0.001 0.699 Column present; SD: Standard deviation; *Pearson Chi-Square test ¥Independent Samples Test; p-value < 0.05 is considered significant (Asymptotic Significance (2-sided)). 5. Discussion The overall prevalence and the pattern of various RE differs among studies as it`s influenced by sociodemographic, genetic, racial and environmental factors [7] . Moreover, using different dioptric cutoff value to measure various RE is also responsible for this finding [8] . Several studies have attempted to determine the prevalence of RE among school-aged children; however, only a few have focused on this problem in adulthood in Upper Egypt [9 – 10] . The current study found that the prevalence of RE among South Egyptian individuals was (63.4%). Also, myopia and hyperopia were found in (32.8% and 32.3%) of participants respectively. Astigmatism existed in (56.3%), amblyopia in (4.3%), and anisometropia in (3.7%) of participants. In consistent with a similar Egyptian study that was conducted among university students aged 18 to 23 years at Mansoura University, which reported a 66% prevalence of RE. In that study, myopia was also slightly more prevalent than hyperopia. However, the prevalence of astigmatism was 43.9%, which is lower compared to our finding of 56.3%. Conversely, anisometropia was found to be more prevalent in the Mansoura University study, affecting 9.2% of participants, compared to 3.7% in our study findings [11] . In a broader context, a study that was conducted in the Delta region of Egypt revealed a significantly higher prevalence of RE at 97.7% among the adult population. This study also reported myopia as more common than hyperopia, with astigmatism affecting 67% of cases and an amblyopia prevalence of 11.5%. The extremely high prevalence of RE in this study could be also attributed to use of low diopter grade to define different RE (myopia ≥ − 0.25 and astigmatism ≥ 0.25 diopter) [12]. Moreover, in south Saudi Arabia 48.8% of 21–23-year-olds university students was found to have RE. This prevalence was also substantially lower than our findings. Myopia was the most frequent RE at 33.8% whereas astigmatism and hyperopia were 10.5% [13]. In the current study RE were higher in Nubian (66.5%) than non-Nubian (60.2%) adult populations. Nubian presented with lower myopia, higher hyperopia and nearly equal astigmatism when compared to non-Nubian population. Similarly significant ethnic differences in prevalence of RE were reported between African Americans and Hispanic White school-aged children. Myopia was more prevalent African American children than Hispanic children (6.6% and 3.7%respectively) while hyperopia predominates among Hispanic children compared to African American children (26.9% vs. 20.8% respectively respectively) [14] . Prevalence of myopia in Singapore was found to be higher among people of Chinese origin compared to Indian or Malaysian descendants (40.1%, 34.1% and 22.1%, respectively). The same outcome was found in Malaysia where Chinese have higher myopia compared to Indian or Malaysian descendants (30.9%, 12.5% and 9.2%, respectively). As each of the three populations living in Singapore and Malaysia have the same genetic character, higher myopia rates in Singapore could be attributed mostly to environmental factors [15] . Similar to the results of this study, a meta-analysis including 47 articles reported that myopia rates in East Asian exceeded 80%, while African rates were much lower, highlighting the influence of hereditary and environmental factors [16] . Our study highlights a significant gender disparity between the non-Nubian males (58.5%) and the Nubian males (44.1%), reflecting the demographic impact of historical displacements on Nubian communities. Consistent with Agha's study, in which the construction of the Aswan Low Dam in 1902 and its expansions submerged extensive Nubian territories, particularly agricultural lands, prompting male workforce migration and leaving a labor gap in these communities. The higher proportion of women in the Nubian population was associated with a greater prevalence of RE, particularly hyperopia [7] . This aligns with Wajuihian and Mashige’s findings, which reported that males were more likely to have myopia and astigmatism, while females showed higher rates of hyperopia across age groups [17] . Consanguinity was reported in higher rates among Nubians with RE (63.4%) than non-Nubians population (4.6%, P < 0.001). Other researchers also stated that consanguinity increases RE and described it among genetic and environmental factors affecting population RE prevalence [18–19]. In contrast, a study from Al-Riyadh area in Saudi Arabia, where consanguinity constitute a widespread culture, found no significant effect of consanguinity on the type or severity of RE despite evidence relating them to ocular genetic or congenital issues [20] . Regarding residency, this study found that (56.7%) of Nubians exist in rural areas, whereas (43.6%) in urban areas (P < 0.001), validating previous research [21] . Environmental variables including lifestyle and education can affect types of RE with natural sunlight and outdoor activities decrease myopia risk. Increased number of rural livings among Nubians is linked to unique RE patterns. Nubians exhibited higher hyperopia ( 50.86% vs. 13.73% in non-Nubians) and lesser myopia (17.36% vs. 48.11% in non-Nubians). Astigmatism remained 45% in both groups. Multiple global studies suggest that rural living increases hyperopia and decreases myopia. Like our Nubian results, Hashemi et al. found that with more outdoor time had lower myopia rates, which may explain Nubians' lower rates [22] . The same observation was supported also by results of previous studies [23] . The study revealed significantly lower educational achievement in Nubians compared to non-Nubians residents. The combination of higher level of education and increase level of myopia was noted among non-Nubians population. Nickels et al. revealed how education influences myopia prevalence corroborating our findings on education and RE [24] . Moreover, Gwiazda et al., Nickels et al. reported that myopia rates were significantly higher in individuals with parents who had a college degree or higher compared to those with lower educational levels [24–25] . This study reveals that visual complaints are significantly associated with RE in Non- Nubians population but not in Nubians (70.1% vs. 26.0%, P < 0.001). This aligns with findings by Naidoo et al. and You et al. , who reported strong links between RE and visual discomfort [26–27] . 6. Conclusion This study concluded a high prevalence of RE in south Egyptian adults (63.4%), with astigmatism being most common. Nubians have higher rates overall, favoring hyperopia, while non-Nubian residents exhibit more myopia and anisometropia. Age associated with RE in Non-Nubians but not Nubians, with no significant role for sex or residence. Consanguinity and higher educational attainment are significantly associated with RE in Nubian population, but not in non-Nubian population. However, visual complaints are significantly more common among those with RE in Non- Nubian population. This study recommends tailored eye health education for Nubians, public campaigns in Aswan to encourage early eye examination, further research on genetic and environmental factors, and targeted eye care strategies through interdisciplinary collaboration for southern Egypt. Declarations Ethics statement: The manuscript was approved by [ethical committee board, Faculty of medicine, Aswan university on IRB\IEC]. IEC ref. NO: Asw,Uni /808/6/23 Consent to participate: Informed consent was obtained, the authors are attesting that the participants were aware of the study's purpose, risks, and benefits. Author Contribution author 1, 2,5 collected the data and revise the manuscriptauthor 4 wrote the manuscriptauthor 3 revise and made the analysis of the manuscript Data Availability Data sets generated during the current study are available from the corresponding author on reasonable request. References Tedja MS, Wojciechowski R, Hysi PG, et al. Genome-wide association meta-analysis highlights light-induced signaling as a driver for refractive error. Nat Genet. 2018;50(6):834-848. doi: 10.1038/s41588-018-0127-7. Williams KM, Verhoeven VJ, Cumberland P, et al. Prevalence of refractive error in Europe: the European Eye Epidemiology Consortium. Eur J Epidemiol. 2015;30(4):305-315. Xulu-Kasaba ZN, Kalinda C. Prevalence of the Burden of Diseases Causing Visual Impairment and Blindness in South Africa in the Period 2010-2020: A Systematic Scoping Review and Meta-Analysis. Trop Med Infect Dis. 2022;7(2):34. Kandel H, Khadka J, Goggin M, Pesudovs K. Impact of refractive error on quality of life: a qualitative study. Clin Exp Ophthalmol. 2017;45(7):677-688. DOI: 10.1111/ceo.12954. Alvarez M, Benedi-Garcia C, Concepcion-Grande P, et al. Early Detection of Refractive Errors by Photorefraction at School Age. Int J Environ Res Public Health. 2022;19(23):15880. WHO. Blindness and vision impairment: Refractive errors,2023. Agha M (2019). Nubia Still Exists: On the Utility of the Nostalgic Space. Humanities, 8,24. Central Agency for Public Mobilization and Statistics (CAPMAS), Statistical year book, 2022., Ministry of health and population., Egypt Massoud MS, Nassr MA. Refractive errors among students enrolled in Assiut University, Egypt. J Egypt Ophthalmol Soc 2015;108:21–25. DOI:10.4103/2090-0686.161373. Abdelrheem, Shaimaa S.a; Gaffer, Mustafa A.b; Gabr, Ahmed F.b, et al. Prevalence of refractive errors in Upper Egypt schoolchildren. Journal of the Egyptian Ophthalmological Society 114(4):p 85-92, Oct–Dec 2021. DOI:10.4103/ejos.ejos_38_21. Mokbel T. Profile of Refractive Errors among Mansoura University Students. Egypt J Ophthalmol.2021,1(2), 58-69.‏ doi.10.21608/ejomos.2021.55407.1000 Ali F, Mourad MS, Rehan, RA, et al. The prevalence of different refractive errors in the Delta region of Egypt. J Egypt Ophthalmol Soc. 2020;113.3: 97-117. DOI:10.4103/ejos.ejos_13_20. Abuallut II, Alhulaibi AA, Alyamani AA, et al. Prevalence of Refractive Errors and its Associated Risk Factors among Medical Students of Jazan University, Saudi Arabia: A Cross-sectional Study. Middle East Afr J Ophthalmol 2021;27(4):210-217. doi: 10.4103/meajo.MEAJO_240_20. Multi-Ethnic Pediatric Eye Disease Study Group. "Prevalence of myopia and hyperopia in 6-to 72-month-old African American and Hispanic children: the Multi-Ethnic Pediatric Eye Disease Study." Ophthalmology 117.1 (2010): 140-147.‏ https://doi.org/10.1016/j.ophtha.2009.06.009. Saw SM, Goh PP, Cheng A, et al. Ethnicity-specific prevalences of refractive errors vary in Asian children in neighbouring Malaysia and Singapore. Br J Ophthalmol. 2006;90(10):1230-1235. doi: 10.1136/bjo.2006.093450. Khoshhal F, Hashemi H, Hooshmand E, et al. The prevalence of refractive errors in the Middle East: a systematic review and meta-analysis. Int Ophthalmol. 2020;40(6):1571-1586. doi: 10.1007/s10792-020-01316-5. Wajuihian SO, Mashige KP. Gender and age distribution of refractive errors in an optometric clinical population. J Optom. 2021 Oct-Dec;14(4):315-327. doi: 10.1016/j.optom.2020.09.002. DOI: 10.1016/j.optom.2020.09.002. Gomez-Salazar F, Campos-Romero A, Gomez-Campaña H, et al. Refractive errors among children, adolescents and adults attending eye clinics in Mexico. Int J Ophthalmol. 2017 May 18;10(5):796-802. doi: 10.18240/ijo.2017.05.23. Awais, A, Akram, S, Awais D. , et al.. Association of Different Type of Refractive Errors with Parental Cousin Marriages: Refractive Errors with Parental Cousin Marriages. Pak J Health Sci. 2023; 4(05), 239–242. DOI: https://doi.org/10.54393/pjhs.v4i05.537. Alsaqr AM. Relationship Between Consanguineous Marriages and Incidence and Severity of Refractive Errors: Invest Ophthalmol Vis Sci. 2019;4. 81-87. DOI:10.11648/j.ijovs.20190404.15. Hopkins NS, Mehanna S. Nubian Encounters: The Story of the Nubian Ethnological Survey, 1961-1964. Oxford University Press 2010. https://aucpress.com/product/nubian-encounters/ Hashemi H, Nabovati P, Yekta A, et al. The prevalence of refractive errors among adult rural populations in Iran. Clin Exp Optom. 2018 Jan;101(1):84-89. doi: 10.1111/cxo.12565. 23. Biswas, S., El Kareh, A., Qureshi, M. et al. The influence of the environment and lifestyle on myopia. J Physiol Anthropol 43, 7 (2024). https://doi.org/10.1186/s40101-024-00354-7. Nickels S, Hopf S, Pfeiffer N, et al. Myopia is associated with education: Results from NHANES 1999-2008. PLoS One. 2019 Jan 29;14(1):e0211196. https://doi.org/10.1371/journal.pone.0211196. Gwiazda J, Deng L, Dias L, et al. Association of education and occupation with myopia in COMET parents. Optom Vis Sci. 2011;88(9):1045-53. doi: 10.1097/OPX.0b013e31822171ad. Naidoo KS, Leasher J, Bourne RR, et al. Vision Loss Expert Group of the Global Burden of Disease Study. Global Vision Impairment and Blindness Due to Uncorrected Refractive Error, 1990-2010. Optom Vis Sci. 2016;93(3):227-34. doi: 10.1097/OPX.0000000000000796. You QS, Choy BK, Chan JC, et al. Prevalence and causes of visual impairment and blindness among adult Chinese in Hong Kong–the Hong Kong Eye Study. Ophthalmic Epidemiol 2020, 27(5), 354-363. DOI: 10.1080/09286586.2020.1755444 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 09 Sep, 2025 Read the published version in Discover Public Health → Version 1 posted Editorial decision: Revision requested 21 Jul, 2025 Reviews received at journal 19 Jul, 2025 Reviews received at journal 17 Jul, 2025 Reviewers agreed at journal 13 Jul, 2025 Reviewers agreed at journal 07 Jul, 2025 Reviews received at journal 06 Jul, 2025 Reviews received at journal 01 Jul, 2025 Reviewers agreed at journal 30 Jun, 2025 Reviewers agreed at journal 28 Jun, 2025 Reviewers invited by journal 23 Jun, 2025 Editor assigned by journal 14 Jun, 2025 Submission checks completed at journal 13 Jun, 2025 First submitted to journal 13 Jun, 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. 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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-6858366","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":475672639,"identity":"b99750a2-b6b2-487c-a8d4-614b4f7b3f6d","order_by":0,"name":"Mahmoud Shetewy Kilany","email":"","orcid":"","institution":"Aswan University","correspondingAuthor":false,"prefix":"","firstName":"Mahmoud","middleName":"Shetewy","lastName":"Kilany","suffix":""},{"id":475672640,"identity":"cc81b151-a9df-4c1c-898b-db2b22c9623a","order_by":1,"name":"Reem Mohamed Yassin","email":"","orcid":"","institution":"Aswan University","correspondingAuthor":false,"prefix":"","firstName":"Reem","middleName":"Mohamed","lastName":"Yassin","suffix":""},{"id":475672641,"identity":"8615242b-448a-4b8a-8eb6-717edda1f94c","order_by":2,"name":"Shaimaa S. Abdelrheem","email":"","orcid":"","institution":"Aswan University","correspondingAuthor":false,"prefix":"","firstName":"Shaimaa","middleName":"S.","lastName":"Abdelrheem","suffix":""},{"id":475672642,"identity":"faa93967-bf68-4aa9-8525-b6981ee14a56","order_by":3,"name":"Maha Sayed","email":"data:image/png;base64,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","orcid":"","institution":"Aswan University","correspondingAuthor":true,"prefix":"","firstName":"Maha","middleName":"","lastName":"Sayed","suffix":""},{"id":475672643,"identity":"a2458f55-4120-4107-8b50-e252007294e1","order_by":4,"name":"Ahmed Fathy Gabr","email":"","orcid":"","institution":"Aswan University","correspondingAuthor":false,"prefix":"","firstName":"Ahmed","middleName":"Fathy","lastName":"Gabr","suffix":""}],"badges":[],"createdAt":"2025-06-10 02:53:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6858366/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6858366/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12982-025-00943-6","type":"published","date":"2025-09-09T15:56:51+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":85617248,"identity":"892e2ce0-6b73-4a37-86f7-921452fc963e","added_by":"auto","created_at":"2025-06-29 14:44:35","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":18323,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eThe overall prevalence of Refractive errors according to each ethnic group in study population\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6858366/v1/64e512612fc15dedd78ae8c0.png"},{"id":91358889,"identity":"026c8a62-531d-4b66-9748-eba23b2dcd39","added_by":"auto","created_at":"2025-09-15 15:58:49","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1241788,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6858366/v1/a81c8c2e-2ce3-44f0-bf7a-dceedcba03af.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence and Patterns of Refractive Errors Among Nubian and Non-Nubian Adults in South Egypt","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eRefractive errors (RE) are common optical aberrations caused by mismatching in the cornea, lens and axial length of the eye focusing power \u003cb\u003e[1]\u003c/b\u003e. Refractive error can be classified into myopia (short or near-sightedness\u0026rsquo;), hyperopia (long or far-sightedness\u0026rsquo;) and astigmatism. In myopia there is excessive refraction at the cornea or lens, or more frequently, an elongated eye (called \"axial myopia\"), causes light to focus on a point anterior to the retina. In hyperopia, the reverse occurs with an image forming posterior to the retinal plane as a result of either inadequate refraction or a short axial length. In astigmatism, the refractive power of the eye is uneven across different meridians \u003cb\u003e[2]\u003c/b\u003e. Despite efforts towards reducing the visual impairment caused by RE, the prevalence of visual impairment is still rising \u003cb\u003e[3]\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eGlobally, uncorrected RE leads to diminished quality of life for millions regardless of age, gender, or ethnicity. Uncorrected RE has significant social and economic consequences, including the restriction of educational and employment opportunities for economically active individuals, the aesthetic appearance, personal health and safety, challenges in daily activities, and various inconveniences in everyday life \u003cb\u003e[4]\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eEarly identification of vision issues can improve one's quality of life, conduct and education \u003cb\u003e[5].\u003c/b\u003e Global programs prioritize the correction of refractive problems and poor vision \u003cb\u003e[6]\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eNubians are an ethnic group indigenous to the region which is now northern Sudan and southern Egypt. They originate from the early inhabitants of the central Nile valley, believed to be one of the earliest cradles of civilization. In the southern valley of Egypt, Nubians differ culturally and ethnically from other Egyptians, they speak Nubian languages as a mother tongue, part of the Northern Eastern Sudanic languages, and Arabic as a second language \u003cb\u003e[7]\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eUp to our knowledge, the prevalence of RE among adults remains insufficiently documented in certain regions of Egypt, particularly in Upper Egypt. Notably, there is a lack of comprehensive data regarding the prevalence of RE among Nubian populations. This highlights the critical need for assessing the prevalence, types, and extent of RE among Nubians, as well as other inhabitants of southern (Upper) Egypt.\u003c/p\u003e"},{"header":"2. Research Methods","content":"\u003cp\u003eThis is a community-based cross-sectional study that was carried out in a randomly selected Nubian and non-Nubian districts. Nubians in Egypt primarily live in south Egypt, especially in Komombo and Naser alnuba. Their population is around 600,000 representing roughly one percent of Egypt's population according to Central Agency for Public Mobilization and Statistics \u003cb\u003e[8]\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eData collection was conducted from July 2023 to November 2024. A total of 1,820 participants (3,640 eyes) aged 18\u0026ndash;40 years were examined, equally divided into Nubian (n\u0026thinsp;=\u0026thinsp;910) and non-Nubian (n\u0026thinsp;=\u0026thinsp;910) groups. Districts were randomly selected from Nubian and non-Nubian areas to ensure representation of the sample.\u003c/p\u003e \u003cp\u003eAll attendees accepted to participate in the study first undertook visual acuity test using tumbling E chart. Patients were selected by the interval random sampling.\u003c/p\u003e \u003cp\u003eThis screening program included Nubian and non-Nubian districts that have been randomly selected. Moreover, all Nubians and non -Nubians between ages of 18 and 40 years living in these districts were examined and included in the study. However, Individuals who had eye surgery, manifest strabismus, or previous history of injuries in the eye were excluded from the study.\u003c/p\u003e \u003cp\u003eThe examinations have been performed in temporary camp by a study team that included one coordinator, one ophthalmologist, two ophthalmic nurses, and one biostatistician.\u003c/p\u003e \u003cp\u003eStandard ophthalmic examination procedure had been used for each study subject and recorded in RE assessment information sheet. Ophthalmic examination included assessment of visual acuity for distance with Snellen\u0026rsquo;s illiterate \u0026lsquo;E\u0026rsquo; chart at room illumination and ocular motility evaluation. The distant vision had been tested with the chart at 6 meters and then participants further investigated by refraction under mydriatics. Mydriatic refraction had been used to determine refractive errors of these target population in this study. Pupils dilated with two drops of 1% tropicamide eye drops, administered three times 5 minutes apart. After 45 minutes, light reflex and pupil dilation were evaluated. Both eyes were examined using the automatic refractometer (RM-800, Topcon, Tokyo, Japan). Slit lamp examination of the anterior segment, media and fundus was done. After completion of eye examination, everyone was given an examination report about his/her eye status. Cases with RE were given written eye examination reports and spectacles.\u003c/p\u003e \u003cp\u003eVision was assessed for recruited adult Nubians and non-Nubians; refraction was done by subjective and objective methods and appropriate spectacles were prescribed. Adult Nubians with no improvement by the above methods and those with other ocular morbidities will be referred to the nearest tertiary hospital for further evaluation and were excluded from the study.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Statistical analysis:\u003c/h2\u003e \u003cp\u003eData were collected, revised, coded, and entered and analyzed using the Statistical Package for the Social Sciences (IBM SPSS, version 26; IBM, New York, USA). The prevalence of RE among the screened subjects was calculated. Qualitative data were presented as numbers and percentages, while quantitative data were expressed as mean and standard deviation (SD). A 95% confidence interval was applied, with a margin of error of 5%. A two-sided P value less than 0.05 was regarded as statistically significant for all analyses.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Ethical considerations","content":"\u003cp\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e The study was approved by the ethics committee of Aswan University Faculty of Medicine. informed consent was taken from all participants.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"4. Results","content":"\u003cp\u003eThe present study included 1820 participants, equally divided between Non- Nubian and Nubian populations (910 each); Socio-demographic characteristics of both groups revealed that Nubians have significant female preponderance, higher rate of consanguinity, resident mostly in rural areas and have lower level of education compared to non-Nubian population (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (table 1).\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(1): Comparison of Socio-Demographic Characteristics between Non- Nubians and Nubian Adult Populations in South Egypt, 2023\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNon- Nubians\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;910)\u003c/p\u003e \u003cp\u003eNo (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNubian\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;910)\u003c/p\u003e \u003cp\u003eNo (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value*\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge (years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD (Range)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.9\u0026thinsp;\u0026plusmn;\u0026thinsp;6.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.7\u0026thinsp;\u0026plusmn;\u0026thinsp;6.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.057\u003csup\u003e\u0026dagger;\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e532 (58.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e401 (44.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e378 (41.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e509 (55.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eResidence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e397 (43.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e516 (56.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e513 (56.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e394 (43.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eConsanguinity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e868 (95.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e333 (36.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42 (4.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e577 (63.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eEducational level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNon-educated\\ Read\u0026amp; write\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68 (7.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e119 (13.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBasic education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29 (3.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48 (5.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e244 (26.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e367 (40.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbove secondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e569 (62.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e376 (41.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eVisual complain\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbsent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e432 (47.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e402 (44.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.158\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePresent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e478 (52.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e508 (55.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e*Chi-square test; \u0026dagger;Independent t-test; p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 is considered significant\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe overall prevalence of RE is 63.4% among South Egyptian inhabitants. The Nubian population exhibits a significantly higher prevalence of RE compared to non-Nubian population (66.5% and 60.2% respectively, p\u0026thinsp;=\u0026thinsp;0.006). The overall prevalence of myopia was noted in 32.8% and hyperopia in 32.3% in south Egyptian population with significantly higher myopia but less hyperopia in non-Nubians compared to Nubian population (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Astigmatism existed in 56.3% of patients with no significant difference between both groups. Amblyopia was presented in 4.3% of participants with no significant difference between both groups (P\u0026thinsp;=\u0026thinsp;0.165). However, anisometropia represents 3.7% which was significantly more prevalent in the non-Nubian group (5.1%) compared to the Nubian group (2.3%), with a P-value of 0.002, indicating a statistically significant difference (table 2, Fig.\u0026nbsp;1).\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(2): Comparison of refractive errors between Non- Nubians and Nubian Adult Populations in South Egypt\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;1820 (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNon- Nubians\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;910 (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNubian\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;910 (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value*\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRefractive errors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1154 (63.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e548 (60.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e606 (66.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.006\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMyopia (\u0026gt; -0.5 D)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e596 (32.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e438 (48.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e158 (17.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHyperopia (\u0026thinsp;\u0026gt;\u0026thinsp;+\u0026thinsp;1 D)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e587 (32.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e125(13.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e462 (50.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAstigmatism (\u0026ge;\u0026thinsp;1D)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1024 (56.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e518 (56.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e506 (55.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.571\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnisometropia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e67 (3.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46 (5.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21 (2.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAmblyopia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e78 (4.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45 (4.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33 (3.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.165\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e*Chi-square test, p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 is significant\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\u003cp\u003eAs regards to mean spherical equivalent, significant difference with hyperopic shift was noted among Nubian population in both eyes (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Otherwise, significant myopic astigmatism was noted in right and left eyes of non-Nubians adults compared to that of Nubian participants (P\u0026thinsp;=\u0026thinsp;0.004 and \u0026lt;\u0026thinsp;0.001 respectively) (table 3).\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(3): Comparison of spherical equivalent and astigmatism between Non- Nubians and Nubian adult populations in South Egypt, 2023\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabc\" border=\"1\"\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eEye status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNon- Nubians\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;910)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNubian\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;910)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-value\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u003cem\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eSpherical Equivalent\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eRight eye\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e0.91\u0026thinsp;\u0026plusmn;\u0026thinsp;0.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eLeft eye\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.61\u0026thinsp;\u0026plusmn;\u0026thinsp;0.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e0.73\u0026thinsp;\u0026plusmn;\u0026thinsp;0.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eAstigmatism\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eRight eye\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.83\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e-0.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eLeft eye\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.75\u0026thinsp;\u0026plusmn;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e-0.36\u0026thinsp;\u0026plusmn;\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eIndependent t-test; p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 is considered significant\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eRegarding the comparison of refraction status in the right eye between the non-Nubian and Nubian populations, a significant difference was found (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). While emmetropia rates were similar in both groups, hyperopia was significantly more prevalent in the Nubian population (40.9%) compared to non-Nubian (10.2%). Conversely, myopia was more common among the non-Nubians (41.9%) than in Nubian (12.3%).\u003c/p\u003e \u003cp\u003eAlso, the comparison of refraction status of left eye between non-Nubian and Nubian populations reveals significant differences (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), with Nubians showing a higher prevalence of hyperopia (39.5% vs 9.6%) and non-Nubian residents exhibiting more myopia (45.5% vs 14.3% in Nubians). Emmetropia rates were similar in both groups.\u003c/p\u003e \u003cp\u003eAstigmatism was found to affect about 56.3% of all participants with no significant difference in the prevalence between the Non- Nubians and Nubian adult populations (p\u0026thinsp;=\u0026thinsp;0.571). Astigmatism was present in 56.9% of the non-Nubian group and 55.6% of the Nubian group, indicating similar patterns of this refractive error in both populations. In both eyes it was found that compound myopic astigmatism was more prevalent in the non-Nubian sample while mixed and compound hyperopic astigmatism was more common in the Nubian sample. (table 2,4)\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(4): Comparison of refraction status of the examined eyes between two studied groups\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabd\" border=\"1\"\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;1820)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNon- Nubians\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;910)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNubian\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;910)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP-value*\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eRefraction status\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(Right eye)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmmetrope (+\u0026thinsp;1 to -0.5 D)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e862 (47.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e436 (47.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e426(46.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHyperope (\u0026thinsp;\u0026gt;\u0026thinsp;+\u0026thinsp;1 D)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e465 (25.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e93 (10.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e372(40.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMyope (\u0026gt; -0.5 D)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e493 (27.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e381 (41.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e112(12.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003eAstigmatism status\u003c/b\u003e (\u0026ge; -1)\u003c/p\u003e \u003cp\u003e\u003cb\u003e(Right eye)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1002(55.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e499 (54.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e503(55.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSimple myopic astigmatism\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22 (1.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16 (1.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6 (0.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCompound myopic astigmatism\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e306 (16.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e253 (27.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e53 (5.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSimple hyperopic astigmatism\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36 (2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12 (1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e24 (2.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCompound hyperopic astigmatism\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e217 (11.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e68 (7.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e149(16.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMixed astigmatism\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e237 (13.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e62 (6.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e175(19.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eRefraction status\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003e(Left eye)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmmetrope (+\u0026thinsp;1 to -0.5 D)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e830 (45.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e409 (44.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e421(46.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHyperope (\u0026thinsp;\u0026gt;\u0026thinsp;+\u0026thinsp;1 D)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e446 (24.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e87 (9.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e359(39.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMyope (\u0026gt; -0.5 D)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e544 (29.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e414 (45.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e130(14.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003eAstigmatism status\u003c/b\u003e (\u0026ge; -1)\u003c/p\u003e \u003cp\u003e\u003cb\u003e(Left eye)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1056(58.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e501(55.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e555(61.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSimple myopic astigmatism\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13 (0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9 (1.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4 (0.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCompound myopic astigmatism\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e316 (17.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e249 (27.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e67 (7.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSimple hyperopic astigmatism\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40 (2.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18 (2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e22 (2.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCompound hyperopic astigmatism\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e142 (7.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e44 (4.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e98 (10.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMixed astigmatism\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e253 (13.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e89 (9.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e164(18.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e*Chi-square test; p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 is considered significant\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAssociations between refractive errors and various socio-demographic characteristics among the non-Nubians and Nubian adult populations were examined. Higher means of age seems to be significantly associated with RE among the non-Nubians. Moreover, a significant relationship between consanguinity and refractive error is observed in the Nubian group, where 61.0% of those with refractive errors report consanguinity (P\u0026thinsp;=\u0026thinsp;0.033). However, no such significant difference is found in the non-Nubian population (P\u0026thinsp;=\u0026thinsp;0.459).\u003c/p\u003e \u003cp\u003eIn the Nubian population, the educational level is significantly associated with refractive error prevalence (P\u0026thinsp;=\u0026thinsp;0.005), indicating that higher educational attainment correlates with an increased prevalence of refractive errors. Conversely, this association is not statistically significant in the non-Nubian population (P\u0026thinsp;=\u0026thinsp;0.074), suggesting that educational level does not have a substantial impact on refractive error prevalence in this group.\u003c/p\u003e \u003cp\u003eVisual complaints are significantly more common among those with refractive errors in non-Nubians (70.1%) compared to those without (26.0%) (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). However, In the Nubian group, the difference is not statistically significant (P\u0026thinsp;=\u0026thinsp;0.699) (table 5).\u003c/p\u003e \u003cp\u003e \u003cb\u003eTable\u0026nbsp;(5): Comparison of refractive errors by socio-demographic variables in Non- Nubians and Nubian adult populations in South Egypt, 2023\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabe\" border=\"1\"\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"2\" nameend=\"c2\" namest=\"c1\" rowspan=\"3\"\u003e \u003cp\u003eStudied Characteristics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eNon- Nubians\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;910)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eNubian\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;910)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eRefractive error\u003c/p\u003e \u003cp\u003eNo. (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eRefractive error\u003c/p\u003e \u003cp\u003eNo. (%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAbsent\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;362)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePresent\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;548)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAbsent\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;305)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePresent\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;605)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eAge (years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30.9\u0026thinsp;\u0026plusmn;\u0026thinsp;7.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.6\u0026thinsp;\u0026plusmn;\u0026thinsp;6.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32.2\u0026thinsp;\u0026plusmn;\u0026thinsp;6.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e33.0\u0026thinsp;\u0026plusmn;\u0026thinsp;6.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eP-value\u003c/b\u003e\u003csup\u003e\u003cb\u003e\u0026yen;\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e0.107\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e222 (61.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e310 (56.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e141 (46.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e260 (43.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e140 (38.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e238 (43.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e164 (53.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e345 (57.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eP-value*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0.154\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e0.351\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eResidence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e161 (44.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e236 (43.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e168 (55.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e348 (57.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e201 (55.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e312 (56.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e137 (44.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e257 (42.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eP-value*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0.674\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e0.483\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eConsanguinity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e343 (94.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e525 (95.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e97 (31.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e236 (39.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (5.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23 (4.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e208 (68.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e369 (61.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eP-value*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0.459\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.033\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e\u003cb\u003eEducational level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNon-educated\\ Read\u0026amp; write\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (6.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43 (7.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37 (12.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e82 (13.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBasic education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (5.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25 (8.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e23 (3.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e91 (25.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e153 (27.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e106 (34.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e261 (43.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbove secondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e228 (63.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e341 (62.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e137 (44.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e239 (39.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eP-value*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0.074\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eVisual complain\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbsent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e268 (74.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e164 (29.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e132(43.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e270 (44.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePresent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e94 (26.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e384 (70.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e173 (56.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e335 (55.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eP-value*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e0.699\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eColumn present; SD: Standard deviation; *Pearson Chi-Square test \u0026yen;Independent Samples Test; p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 is considered significant (Asymptotic Significance (2-sided)).\u003c/p\u003e"},{"header":"5. Discussion","content":"\u003cp\u003eThe overall prevalence and the pattern of various RE differs among studies as it`s influenced by sociodemographic, genetic, racial and environmental factors \u003cb\u003e[7]\u003c/b\u003e. Moreover, using different dioptric cutoff value to measure various RE is also responsible for this finding \u003cb\u003e[8]\u003c/b\u003e. Several studies have attempted to determine the prevalence of RE among school-aged children; however, only a few have focused on this problem in adulthood in Upper Egypt \u003cb\u003e[9\u003c/b\u003e\u0026ndash;\u003cb\u003e10]\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eThe current study found that the prevalence of RE among South Egyptian individuals was (63.4%). Also, myopia and hyperopia were found in (32.8% and 32.3%) of participants respectively. Astigmatism existed in (56.3%), amblyopia in (4.3%), and anisometropia in (3.7%) of participants.\u003c/p\u003e \u003cp\u003eIn consistent with a similar Egyptian study that was conducted among university students aged 18 to 23 years at Mansoura University, which reported a 66% prevalence of RE. In that study, myopia was also slightly more prevalent than hyperopia. However, the prevalence of astigmatism was 43.9%, which is lower compared to our finding of 56.3%. Conversely, anisometropia was found to be more prevalent in the Mansoura University study, affecting 9.2% of participants, compared to 3.7% in our study findings \u003cb\u003e[11]\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eIn a broader context, a study that was conducted in the Delta region of Egypt revealed a significantly higher prevalence of RE at 97.7% among the adult population. This study also reported myopia as more common than hyperopia, with astigmatism affecting 67% of cases and an amblyopia prevalence of 11.5%. The extremely high prevalence of RE in this study could be also attributed to use of low diopter grade to define different RE (myopia\u0026thinsp;\u003cb\u003e\u0026ge;\u0026thinsp;\u0026minus;\u003c/b\u003e\u0026thinsp;0.25 and astigmatism\u0026thinsp;\u003cb\u003e\u0026ge;\u003c/b\u003e\u0026thinsp;0.25 diopter) \u003cb\u003e[12].\u003c/b\u003e\u003c/p\u003e \u003cp\u003eMoreover, in south Saudi Arabia 48.8% of 21\u0026ndash;23-year-olds university students was found to have RE. This prevalence was also substantially lower than our findings. Myopia was the most frequent RE at 33.8% whereas astigmatism and hyperopia were 10.5% \u003cb\u003e[13].\u003c/b\u003e\u003c/p\u003e \u003cp\u003eIn the current study RE were higher in Nubian (66.5%) than non-Nubian (60.2%) adult populations. Nubian presented with lower myopia, higher hyperopia and nearly equal astigmatism when compared to non-Nubian population. Similarly significant ethnic differences in prevalence of RE were reported between African Americans and Hispanic White school-aged children. Myopia was more prevalent African American children than Hispanic children (6.6% and 3.7%respectively) while hyperopia predominates among Hispanic children compared to African American children (26.9% vs. 20.8% respectively respectively) \u003cb\u003e[14]\u003c/b\u003e.\u003c/p\u003e \u003cp\u003ePrevalence of myopia in Singapore was found to be higher among people of Chinese origin compared to Indian or Malaysian descendants (40.1%, 34.1% and 22.1%, respectively). The same outcome was found in Malaysia where Chinese have higher myopia compared to Indian or Malaysian descendants (30.9%, 12.5% and 9.2%, respectively). As each of the three populations living in Singapore and Malaysia have the same genetic character, higher myopia rates in Singapore could be attributed mostly to environmental factors \u003cb\u003e[15]\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eSimilar to the results of this study, a meta-analysis including 47 articles reported that myopia rates in East Asian exceeded 80%, while African rates were much lower, highlighting the influence of hereditary and environmental factors \u003cb\u003e[16]\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eOur study highlights a significant gender disparity between the non-Nubian males (58.5%) and the Nubian males (44.1%), reflecting the demographic impact of historical displacements on Nubian communities. Consistent with \u003cb\u003eAgha's\u003c/b\u003e study, in which the construction of the Aswan Low Dam in 1902 and its expansions submerged extensive Nubian territories, particularly agricultural lands, prompting male workforce migration and leaving a labor gap in these communities. The higher proportion of women in the Nubian population was associated with a greater prevalence of RE, particularly hyperopia \u003cb\u003e[7]\u003c/b\u003e. This aligns with \u003cb\u003eWajuihian and Mashige\u0026rsquo;s\u003c/b\u003e findings, which reported that males were more likely to have myopia and astigmatism, while females showed higher rates of hyperopia across age groups \u003cb\u003e[17]\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eConsanguinity was reported in higher rates among Nubians with RE (63.4%) than non-Nubians population (4.6%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Other researchers also stated that consanguinity increases RE and described it among genetic and environmental factors affecting population RE prevalence \u003cb\u003e[18\u0026ndash;19].\u003c/b\u003e\u003c/p\u003e \u003cp\u003eIn contrast, a study from Al-Riyadh area in Saudi Arabia, where consanguinity constitute a widespread culture, found no significant effect of consanguinity on the type or severity of RE despite evidence relating them to ocular genetic or congenital issues \u003cb\u003e[20]\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eRegarding residency, this study found that (56.7%) of Nubians exist in rural areas, whereas (43.6%) in urban areas (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), validating previous research \u003cb\u003e[21]\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eEnvironmental variables including lifestyle and education can affect types of RE with natural sunlight and outdoor activities decrease myopia risk. Increased number of rural livings among Nubians is linked to unique RE patterns. Nubians exhibited higher hyperopia (\u003cb\u003e50.86%\u003c/b\u003e vs. \u003cb\u003e13.73%\u003c/b\u003e in non-Nubians) and lesser myopia (17.36% vs. 48.11% in non-Nubians). Astigmatism remained 45% in both groups. Multiple global studies suggest that rural living increases hyperopia and decreases myopia. Like our Nubian results, \u003cb\u003eHashemi et al.\u003c/b\u003e found that with more outdoor time had lower myopia rates, which may explain Nubians' lower rates \u003cb\u003e[22]\u003c/b\u003e. The same observation was supported also by results of previous studies \u003cb\u003e[23]\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eThe study revealed significantly lower educational achievement in Nubians compared to non-Nubians residents. The combination of higher level of education and increase level of myopia was noted among non-Nubians population. \u003cb\u003eNickels et al.\u003c/b\u003e revealed how education influences myopia prevalence corroborating our findings on education and RE \u003cb\u003e[24]\u003c/b\u003e. Moreover, \u003cb\u003eGwiazda et al., Nickels et al.\u003c/b\u003e reported that myopia rates were significantly higher in individuals with parents who had a college degree or higher compared to those with lower educational levels \u003cb\u003e[24\u0026ndash;25]\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eThis study reveals that visual complaints are significantly associated with RE in Non- Nubians population but not in Nubians (70.1% vs. 26.0%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). This aligns with findings by \u003cb\u003eNaidoo et al.\u003c/b\u003e and \u003cb\u003eYou et al.\u003c/b\u003e, who reported strong links between RE and visual discomfort \u003cb\u003e[26\u0026ndash;27]\u003c/b\u003e.\u003c/p\u003e"},{"header":"6. Conclusion","content":"\u003cp\u003eThis study concluded a high prevalence of RE in south Egyptian adults (63.4%), with astigmatism being most common. Nubians have higher rates overall, favoring hyperopia, while non-Nubian residents exhibit more myopia and anisometropia. Age associated with RE in Non-Nubians but not Nubians, with no significant role for sex or residence. Consanguinity and higher educational attainment are significantly associated with RE in Nubian population, but not in non-Nubian population. However, visual complaints are significantly more common among those with RE in Non- Nubian population. This study recommends tailored eye health education for Nubians, public campaigns in Aswan to encourage early eye examination, further research on genetic and environmental factors, and targeted eye care strategies through interdisciplinary collaboration for southern Egypt.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics statement:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe manuscript was approved by [ethical committee board, Faculty of medicine, Aswan university on IRB\\IEC].\u003c/p\u003e\n\u003cp\u003eIEC ref. NO: Asw,Uni /808/6/23\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained, the authors are attesting that the participants were aware of the study\u0026apos;s purpose, risks, and benefits.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eauthor 1, 2,5 collected the data and revise the manuscriptauthor 4 wrote the manuscriptauthor 3 revise and made the analysis of the manuscript\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eData sets generated during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eTedja MS, Wojciechowski R, Hysi PG, et al. Genome-wide association meta-analysis highlights light-induced signaling as a driver for refractive error. Nat Genet. 2018;50(6):834-848. doi: 10.1038/s41588-018-0127-7.\u003c/li\u003e\n \u003cli\u003eWilliams KM, Verhoeven VJ, Cumberland P, et al. Prevalence of refractive error in Europe: the European Eye Epidemiology Consortium. Eur J Epidemiol. 2015;30(4):305-315.\u003c/li\u003e\n \u003cli\u003eXulu-Kasaba ZN, Kalinda C. Prevalence of the Burden of Diseases Causing Visual Impairment and Blindness in South Africa in the Period 2010-2020: A Systematic Scoping Review and Meta-Analysis. Trop Med Infect Dis. 2022;7(2):34.\u003c/li\u003e\n \u003cli\u003eKandel H, Khadka J, Goggin M, Pesudovs K. Impact of refractive error on quality of life: a qualitative study. Clin Exp Ophthalmol. 2017;45(7):677-688. DOI: 10.1111/ceo.12954.\u003c/li\u003e\n \u003cli\u003eAlvarez M, Benedi-Garcia C, Concepcion-Grande P, et al. Early Detection of Refractive Errors by Photorefraction at School Age. Int J Environ Res Public Health. 2022;19(23):15880.\u003c/li\u003e\n \u003cli\u003eWHO. Blindness and vision impairment: Refractive errors,2023.\u003c/li\u003e\n \u003cli\u003eAgha M (2019). Nubia Still Exists: On the Utility of the Nostalgic Space. Humanities, 8,24.\u003c/li\u003e\n \u003cli\u003eCentral Agency for Public Mobilization and Statistics (CAPMAS), Statistical year book, 2022., Ministry of health and population., Egypt\u003c/li\u003e\n \u003cli\u003eMassoud MS, Nassr MA. Refractive errors among students enrolled in Assiut University, Egypt. J Egypt Ophthalmol Soc 2015;108:21–25. DOI:10.4103/2090-0686.161373.\u003c/li\u003e\n \u003cli\u003eAbdelrheem, Shaimaa S.a; Gaffer, Mustafa A.b; Gabr, Ahmed F.b, et al. Prevalence of refractive errors in Upper Egypt schoolchildren. Journal of the Egyptian Ophthalmological Society 114(4):p 85-92, Oct–Dec 2021. DOI:10.4103/ejos.ejos_38_21.\u003c/li\u003e\n \u003cli\u003eMokbel T. Profile of Refractive Errors among Mansoura University Students. Egypt J Ophthalmol.2021,1(2), 58-69.‏ doi.10.21608/ejomos.2021.55407.1000\u003c/li\u003e\n \u003cli\u003e Ali F, Mourad MS, Rehan, RA, et al. The prevalence of different refractive errors in the Delta region of Egypt. J Egypt Ophthalmol Soc. 2020;113.3: 97-117. DOI:10.4103/ejos.ejos_13_20.\u003c/li\u003e\n \u003cli\u003e Abuallut II, Alhulaibi AA, Alyamani AA, et al. Prevalence of Refractive Errors and its Associated Risk Factors among Medical Students of Jazan University, Saudi Arabia: A Cross-sectional Study. Middle East Afr J Ophthalmol 2021;27(4):210-217. doi: 10.4103/meajo.MEAJO_240_20.\u003c/li\u003e\n \u003cli\u003e Multi-Ethnic Pediatric Eye Disease Study Group. \"Prevalence of myopia and hyperopia in 6-to 72-month-old African American and Hispanic children: the Multi-Ethnic Pediatric Eye Disease Study.\" Ophthalmology 117.1 (2010): 140-147.‏ https://doi.org/10.1016/j.ophtha.2009.06.009. \u003c/li\u003e\n \u003cli\u003e Saw SM, Goh PP, Cheng A, et al. Ethnicity-specific prevalences of refractive errors vary in Asian children in neighbouring Malaysia and Singapore. Br J Ophthalmol. 2006;90(10):1230-1235. doi: 10.1136/bjo.2006.093450.\u003c/li\u003e\n \u003cli\u003e Khoshhal F, Hashemi H, Hooshmand E, et al. The prevalence of refractive errors in the Middle East: a systematic review and meta-analysis. Int Ophthalmol. 2020;40(6):1571-1586. doi: 10.1007/s10792-020-01316-5.\u003c/li\u003e\n \u003cli\u003eWajuihian SO, Mashige KP. Gender and age distribution of refractive errors in an optometric clinical population. J Optom. 2021 Oct-Dec;14(4):315-327. doi: 10.1016/j.optom.2020.09.002. DOI: 10.1016/j.optom.2020.09.002. \u003c/li\u003e\n \u003cli\u003eGomez-Salazar F, Campos-Romero A, Gomez-Campaña H, et al. Refractive errors among children, adolescents and adults attending eye clinics in Mexico. Int J Ophthalmol. 2017 May 18;10(5):796-802. doi: 10.18240/ijo.2017.05.23.\u003c/li\u003e\n \u003cli\u003eAwais, A, Akram, S, Awais D. , et al.. Association of Different Type of Refractive Errors with Parental Cousin Marriages: Refractive Errors with Parental Cousin Marriages. Pak J Health Sci. 2023; 4(05), 239–242. DOI: https://doi.org/10.54393/pjhs.v4i05.537.\u003c/li\u003e\n \u003cli\u003eAlsaqr AM. Relationship Between Consanguineous Marriages and Incidence and Severity of Refractive Errors: Invest Ophthalmol Vis Sci. 2019;4. 81-87. DOI:10.11648/j.ijovs.20190404.15.\u003c/li\u003e\n \u003cli\u003eHopkins NS, Mehanna S. Nubian Encounters: The Story of the Nubian Ethnological Survey, 1961-1964. Oxford University Press 2010. https://aucpress.com/product/nubian-encounters/\u003c/li\u003e\n \u003cli\u003eHashemi H, Nabovati P, Yekta A, et al. The prevalence of refractive errors among adult rural populations in Iran. Clin Exp Optom. 2018 Jan;101(1):84-89. doi: 10.1111/cxo.12565.\u003c/li\u003e\n \u003cli\u003e23. Biswas, S., El Kareh, A., Qureshi, M. et al. The influence of the environment and lifestyle on myopia. J Physiol Anthropol 43, 7 (2024). https://doi.org/10.1186/s40101-024-00354-7. \u003c/li\u003e\n \u003cli\u003e Nickels S, Hopf S, Pfeiffer N, et al. Myopia is associated with education: Results from NHANES 1999-2008. PLoS One. 2019 Jan 29;14(1):e0211196. https://doi.org/10.1371/journal.pone.0211196.\u003c/li\u003e\n \u003cli\u003e Gwiazda J, Deng L, Dias L, et al. Association of education and occupation with myopia in COMET parents. Optom Vis Sci. 2011;88(9):1045-53. doi: 10.1097/OPX.0b013e31822171ad.\u003c/li\u003e\n \u003cli\u003e Naidoo KS, Leasher J, Bourne RR, et al. Vision Loss Expert Group of the Global Burden of Disease Study. Global Vision Impairment and Blindness Due to Uncorrected Refractive Error, 1990-2010. Optom Vis Sci. 2016;93(3):227-34. doi: 10.1097/OPX.0000000000000796.\u003c/li\u003e\n \u003cli\u003e You QS, Choy BK, Chan JC, et al. Prevalence and causes of visual impairment and blindness among adult Chinese in Hong Kong–the Hong Kong Eye Study. Ophthalmic Epidemiol 2020, 27(5), 354-363. DOI: 10.1080/09286586.2020.1755444\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Refractive errors, Nubian, hyperopia, myopia, South Egypt","lastPublishedDoi":"10.21203/rs.3.rs-6858366/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6858366/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRefractive errors are regarded as a public health challenge; being the most common eye condition resulting from discrepancies in the cornea, lens, and axial length of the eye's focusing power and affecting all age groups. Refractive error is the leading cause of vision impairment contributing to 123.7 million cases of moderate to severe distance vision impairment or blindness. Intricate interactions between genetic and lifestyle factors result in refractive errors. Prevalence, pattern and degree of refractive errors were proved by many studies to be affected by racial and ethnic variations. Nubians differ culturally and ethnically from other Egyptians. Nubians are an ethnic group indigenous to the region which is now northern Sudan and southern Egypt.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePurpose:\u003c/strong\u003e The present study aims to detect the prevalence and patterns of different refractive errors among Nubian and non- Nubian adults in South Egypt.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eA community-based cross-sectional study that was carried out in randomly selected Nubian and non-Nubian districts. The study included 1820 adult individuals. They were divided into two groups (910 persons each) representing Nubian and non-Nubians adults in south Egypt. Following standard ophthalmic examination, autorefraction under mydriatics was done. Data was collected and tabulated\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eOverall prevalence of refractive errors was 63.4% among South Egyptian. Refractive Errors were found in 66.5% of Nubians and in 60.2% of non- Nubians. Astigmatism existed in 56.3% of patients with no significant difference between both groups. Nubians were significantly more hyperopic and less myopic than non-Nubians (p\u0026lt;0.001). Amblyopia was presented in 4.3% of participants and anisometropia in 3.7% which was significantly higher in non- Nubians (p =0.002).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eNubians exhibit a higher prevalence of overall refractive errors compared to the non- Nubians, with a marked tendency towards hyperopia.\u003c/p\u003e","manuscriptTitle":"Prevalence and Patterns of Refractive Errors Among Nubian and Non-Nubian Adults in South Egypt","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-29 14:44:30","doi":"10.21203/rs.3.rs-6858366/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-07-21T15:46:55+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-19T14:01:10+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-17T17:51:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"185174259815259397662901255115437873475","date":"2025-07-13T19:08:34+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"325953138009815649184901859384777564057","date":"2025-07-07T15:28:59+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-06T18:30:06+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-01T08:22:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"34051493880203247446330561514040638176","date":"2025-06-30T10:27:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"132543011135667052056700150223509391477","date":"2025-06-28T16:10:09+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-06-23T18:57:42+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-06-14T10:39:50+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-06-13T17:21:23+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Public Health","date":"2025-06-13T17:18:25+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"538ce3db-ce71-4c86-89b2-73cf88ad4845","owner":[],"postedDate":"June 29th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-09-15T15:57:48+00:00","versionOfRecord":{"articleIdentity":"rs-6858366","link":"https://doi.org/10.1186/s12982-025-00943-6","journal":{"identity":"discover-public-health","isVorOnly":false,"title":"Discover Public Health"},"publishedOn":"2025-09-09 15:56:51","publishedOnDateReadable":"September 9th, 2025"},"versionCreatedAt":"2025-06-29 14:44:30","video":"","vorDoi":"10.1186/s12982-025-00943-6","vorDoiUrl":"https://doi.org/10.1186/s12982-025-00943-6","workflowStages":[]},"version":"v1","identity":"rs-6858366","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6858366","identity":"rs-6858366","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}