Knowledge, attitudes, and preventive behaviors regarding myopia among adults in Palestine: a cross-sectional online convenience-sample survey

BACKGROUND: Myopia is a growing cause of visual impairment and ocular morbidity, yet evidence concerning public understanding and preventive behavior in Palestine is limited. This study assessed awareness, knowledge, attitudes, and preventive behaviors regarding myopia among adults recruited online in Palestine and examined associated sociodemographic and eye-health characteristics. METHODS: A cross-sectional online survey was conducted from 14 November to 30 December 2025. Adults aged at least 18 years who resided in Palestine, completed the Arabic questionnaire, provided electronic consent, and did not report a healthcare-related occupation or field of study were eligible. The final analysis included all eligible respondents, irrespective of prior awareness of myopia. Domain scores were analyzed continuously using descriptive statistics, Welch group-comparison tests, Pearson correlations, and forced-entry multivariable linear regression with heteroscedasticity-robust standard errors. RESULTS: Of 702 submitted forms, 594 were eligible after exclusion of 11 non-consenting submissions, five later exact duplicate response patterns, and 92 respondents with explicit healthcare-related occupations or studies. The sample was predominantly aged 18-29 years (83.5%), female (75.8%), and tertiary/postgraduate educated (85.9%). Prior awareness of myopia was reported by 585 participants (98.5%, 95% CI 97.1%-99.2%). Mean knowledge, attitude, and preventive-behavior scores were 49.26 ± 7.04 of 66 (74.6% of the maximum), 37.06 ± 4.84 of 48 (77.2%), and 15.86 ± 2.71 of 24 (66.1%), respectively. Cronbach's alpha was 0.673, 0.588, and 0.367, respectively. Knowledge and attitude were moderately correlated (r = 0.402, 95% CI 0.332-0.467; p < 0.001), whereas correlations involving preventive behavior were negligible and non-significant. In adjusted analysis, female sex, tertiary/postgraduate education, employment, and clinician-diagnosed myopia were associated with more favorable attitude scores. Preventive-behavior findings were exploratory because of poor internal consistency. CONCLUSION: In this young, highly educated, digitally reached non-healthcare sample, normalized attitude and knowledge scores exceeded the preventive-behavior score. The findings are descriptive of the recruited sample and should not be interpreted as population estimates for Palestinian adults. Representative mixed-mode studies, formal Arabic validation, and locally evaluated primary-care, school, optometrist-led, and digital eye-health interventions are needed.