Literature Review: Characteristics of Refractive Errors in Children

Refractive errors are among the leading causes of preventable visual impairment in children and may adversely affect visual development, quality of life, and academic performance. This literature review aimed to describe the characteristics of refractive errors in children based on their type, age and gender distribution, refractive severity, and associated risk factors. A narrative literature review was conducted using secondary data from international journals, national journals, and ClinicalKey resources published between 2021 and 2026. The literature search identified 468 articles, of which 12 met the inclusion criteria following title and abstract screening. The findings showed that myopia was the most prevalent refractive error among children, followed by astigmatism. The prevalence of myopia increased with age, particularly among children aged 6–12 years, and was reported to be higher among girls than boys. Myopia progression generally peaked during adolescence, especially in children with an earlier onset. The severity of refractive errors was closely associated with ocular biometric changes, particularly axial elongation and alterations in the axial length-to-corneal radius ratio. Environmental and behavioral factors, including prolonged near-work, excessive digital device use, and limited outdoor activity, were consistently associated with an increased risk of myopia. These findings emphasize the importance of periodic vision screening, early refractive correction, responsible screen-time management, and increased outdoor activity to prevent the onset and progression of refractive errors in children.