Distribution and factors associated with refractive errors among young adults attending ophthalmic clinics in Iraq: a multicenter cross-sectional study.

Objectives: To describe the clinic-based distribution of myopia, hyperopia, and astigmatism among young Iraqi adults and to examine demographic, social, familial, and self-reported behavioral factors associated with myopia and high-severity refractive errors. Materials and methods: This multicenter, clinic-based, cross-sectional study included 4,340 consecutive young adult attendees at three tertiary ophthalmic centers. Right-eye sphere and cylinder values were standardized to minus-cylinder notation before spherical equivalent (SE), and refractive outcomes were derived. Subgroup percentages were calculated using the relevant subgroup denominator, and multivariable logistic regression was used to evaluate associated factors. Results: In the analytic sample, myopia (SE ≤ -0.50 D) occurred in 51.2%, hyperopia (SE ≥ +0.50 D) in 37.0%, and astigmatism (|cylinder| ≥ 0.50 D) in 66.4%; astigmatism overlapped with spherical refractive status. Myopia was more frequent among women than men (53.6% vs 45.6%). In the adjusted model, female sex, age 28-32 years, a positive family history of refractive error, sleep duration ≤6 hours, and longer daily electronic-device use were associated with higher odds of myopia, whereas office work, manual work, and unemployment were associated with lower odds than student status. Conclusions: Refractive errors were frequent among young adults attending tertiary ophthalmic clinics in Iraq. The observed associations with demographic, familial, social, and behavioral factors provide clinically useful information for targeted refractive assessment, counseling, and service planning in young adults. Population-based longitudinal studies are needed to confirm the generalizability and temporal nature of these associations.