Many eye conditions, including cataract, glaucoma, and diabetic retinopathy, are among the major causes of blindness in the world. Low health knowledge of these illnesses and their sequelae reduces opportunities for early intervention and prevention by delaying seeking medical care. Because of this, increasing public knowledge of ocular disorders is crucial for their early diagnosis and treatment, which lessens the burden of visual impairment [1]. There have been many studies on the subject worldwide but fewer in the Middle East; hence, the subject needs more investigation. The results of these studies and research were significant. In a study of participants 711, the majority had a basic understanding of prevalent eye disease and its causes. Hence, our findings indicate the necessity for eye healthcare interventions concentrating on knowledge gaps, particularly on glaucoma [2]. In a different survey, the most frequently given accurate response was that getting enough sleep is essential for general eye health (92.1%), followed by routine eye exams even in the absence of eye disease (89.1%). The study’s results showed that the population under investigation in the study region knew only a moderate amount about eye conditions and eye care. The highest levels of awareness were for general eye care, while the lowest was for glaucoma and cataracts [3]. Another study found that 31%, 38%, 37%, and 52% of the study group, respectively, were aware of cataract, glaucoma, DR (Diabetic Retinopathy), and DED (Dry Eye Disease) []. According to the findings of further study, the participants’ acceptable knowledge (score \(\geq\) 50%) was low regarding refractive errors (63%), paediatric eye disorders (51.5%), and glaucoma (14.8%), and high regarding ocular trauma (81.2%), diabetes (88.6%), and other general eye diseases (91.3%) [5]. The Kingdom of Saudi Arabia introduced the 2030 Vision in April 2016. Its goals included maximizing and better utilizing the capacity of hospitals and healthcare facilities, improving the caliber of those facilities’ therapeutic and preventive healthcare services, and providing healthcare through public corporations to both improve that sector’s quality and get ready for the long-term advantages of privatization [6]. Regarding the degree of awareness of prevalent eye disorders globally, varying results have been observed [5, 7, 8, 9]. To date, more studies are needed to assess the awareness of common eye diseases in Saudi Arabia. This study was carried out to assess the awareness of common eye diseases among college students at a Saudi University.

This study employed a cross-sectional survey design to investigate the awareness of common eye diseases among college students at Prince Sattam bin Abdulaziz University (PSAU). The research design involved surveying 500 participants, selected through stratified random sampling. The sample consisted of college students aged 18-25 years who were currently enrolled at PSAU, with participants stratified based on gender, academic year, and college. Data was collected using a self-administered questionnaire divided into two sections. The first section gathered demographic information, such as age, gender, academic year, and college. The second section focused on assessing awareness of common eye diseases through multiple-choice questions. The questionnaire, adapted with modifications from a validated survey []. Questions aimed to evaluate awareness regarding specific eye conditions like glaucoma, cataracts, diabetic retinopathy, and dry eye disease. Additionally, participants were asked about their familiarity with the diseases, their knowledge of associated risk factors, and the source of their information. The investigators meticulously reviewed responses to ensure participants’ comprehension of the questionnaire. The survey also delved into participants’ awareness of the diseases’ impact on vision, addressing whether these conditions are blinding, preventable, treatable, and if vision returns to normal following treatment. A. Statistical Analysis A statistical analysis using both descriptive and inferential methods was performed on the data. Frequencies and percentages were computed and summarised as basic descriptive statistics of the sociodemographic traits and other categorical variables. The central tendency and dispersion metrics for continuous variables were presented as means (M) and standard deviations (SD), respectively. One score was assigned to each of the four questions that tested the respondent’s knowledge about eye illnesses. Each participant’s score was added together, along with their level of knowledge about each eye condition. As a result, each eye illness might have a maximum score of 0-4. The participants’ knowledge scores about various eye diseases were compared based on their family history and sociodemographic variables. The Kruskal-Wallis test and the non-parametric Mann-Whitney U test was the two inferential statistical analyses used in the comparison. A 95% confidence interval was indicated by a p-value of 0.05, which was considered significant. For all statistical computations, IBM SPSS version 27.0.1 was used.

A. Sociodemographic Characteristics Among the 579 participants, a majority of 376 were male, constituting 64.9% of the sample, while Two hundred three participants were female, making up 35.1% of the total. The average age of the participants was 20.9 years, with a standard deviation of 2.3, indicating a relatively homogeneous age distribution. In terms of academic year, the largest proportion of students were in their first year (24.9%), followed by the third year (20.4%), and medical students represented 50.1% of the total, with non-medical students comprising the remaining 49.9%. This demographic snapshot provides a clear overview of the composition of our study’s participant pool, which encompasses a diverse range of students in terms of gender, age, academic progression, and college affiliation (Table 1). Table 1: Sociodemographic characteristics of the participants     N % M SD Sex Female 203 35.1%   Male 376 64.9%   Age 20.9 2.3 Academic year Graduate 93 16.1% 5th Year 34 5.9% 4th Year 54 9.3% 6th Year 32 5.5% 1st Year 144 24.9% 2nd Year 104 18.0% 3rd Year 118 20.4% College Medical 290 50.1% Non-medical 289 49.9% B. Family History, Awareness, Sources of Information of Eye Diseases Notably, a majority of participants (62.7%) reported no family history of these diseases. Among those who did report a family history, dry eye was the most frequently mentioned condition, with 27.8% of participants noting its presence in their families. Cataract, glaucoma, and diabetic retinopathy had lower reported family histories, at 12.3%, 5.9%, and 3.5%, respectively. For participants with family members affected by these conditions, parents were often the closest relatives with these diseases. Regarding awareness, the majority of participants were aware of dry eye (60.3%), followed by cataract (38.7%) and glaucoma (33.3%). Notably, 26.9% reported no awareness of any eye disease, highlighting the need for improved knowledge dissemination. In terms of sources of information, the internet emerged as the most significant source, with 46.7% of participants citing it as their informational channel. Family, friends, and relatives were also prominent sources (35.4%). Educational sources, such as courses and lectures, played a role for 27% of participants, and ophthalmology clinics (25.5%) and previous personal history (17.3%) were other notable sources (Table 2, Figure 1). Table 2: Family history, awareness, and sources of information of eye diseases of the participants     N % Is there any of these diseases in your family? None 363 62.7% Dry Eye 161 27.8% Cataract 71 12.3% Glaucoma 34 5.9% Diabetic Retinopathy 20 3.5% Relationship to family member with glaucoma Parents 25 92.6% Sister 1 3.7% Brother 1 3.7% Relationship to the family member with cataract? Parents 61 92.4% Brother 4 6.1% Sister 3 4.5% Relation to family member with diabetic retinopathy Parents 21 77.8% Sister 4 14.8% Brother 4 14.8% Relation to family member with dry eye Parents 76 51.4% Sister 71 48.0% Brother 71 48.0% Are you aware of any eye disease Dry Eye 349 60.3% Cataract 224 38.7% Glaucoma 193 33.3% None 156 26.9% Diabetic Retinopathy 127 21.9% What is your source of information about this disease? Internet 256 46.7% Family, Friend, Relatives 194 35.4% Course/Lecture 148 27.0% Ophthalmology Clinic 140 25.5% Previous History 95 17.3% Reading e.g., Book, newspaper, magazines 87 15.9% Campaign 63 11.5% Media e.g. TV, Radio 56 10.2% Optometry Clinic 32 5.8% Figure 1: Sources of information about eye disease C. Risk Factors of Eye Diseases For diabetic retinopathy, a substantial proportion of participants (45.0%) recognized physical diseases like high blood pressure and diabetes as risk factors. Family history (36.5%) and age (29.7%) were also acknowledged as contributors to the development of this condition. Concerning dry eye, a significant number of participants (44.3%) mentioned ’other’ risk factors, indicating a certain level of uncertainty or less commonly known factors. Age (35.0%) and family history (31.0%) were also acknowledged as potential risk factors, along with the influence of medications (30.8%) and physical diseases like high blood pressure and diabetes (19.6%). For cataract, age was widely recognized as a risk factor by the majority of participants (52.3%). Family history (33.4%) and the influence of physical diseases (26.0%) were also identified as contributing factors. The ’other’ category was mentioned by 25.1% of participants, while medications (21.0%) were also acknowledged as a potential risk factor. Regarding glaucoma, the acknowledgment of age (42.6%) and family history (39.1%) as risk factors was quite prominent. Participants also recognized physical diseases like high blood pressure and diabetes (33.0%) and mentioned ’other’ factors (27.6%) as contributors. Medications (23.3%) were noted to a slightly lesser extent (Table 3). Table 3: Awareness of risk factors of eye diseases of the participants     N % Can you mention any risk factors for the development of diabetic retinopathy? Physical diseases such as high blood pressure and diabetes 249 45.0% Family history 202 36.5% Age 164 29.7% Other 147 26.6% Medications 83 15.0% Can you mention any risk factors for dry eye? Other 224 44.3% Age 177 35.0% Family history 157 31.0% Medications 156 30.8% Physical diseases such as high blood pressure and diabetes 99 19.6% Can you mention any risk factors for cataract? Age 296 52.3% Family history 189 33.4% Physical diseases such as high blood pressure and diabetes 147 26.0% Other 142 25.1% Medications 119 21.0% Can you mention any risk factors for glaucoma? Age 229 42.6% Family history 210 39.1% Physical diseases such as high blood pressure and diabetes 177 33.0% Other 148 27.6% Medications 125 23.3% D. Knowledge of Eye Diseases Table 4 provides an overview of the participants’ knowledge regarding four common eye diseases: cataract, glaucoma, diabetic retinopathy, and dry eye. The data highlights varying levels of awareness. For cataract, while 58.4% recognized it as a treatable condition, 50.9% were unsure if it causes blindness. Regarding glaucoma, 42.5% knew that it can cause blindness, and 45.1% were aware that it can be treated. For diabetic retinopathy, 37.8% knew it can be avoided, and 32.0% recognized that it can be treated. The majority (65.6%) believed that vision could return to normal after treatment. For dry eye, 67.0% recognized it can be avoided, and 68.7% acknowledged its treatability. While 50.9% knew dry eye does not cause blindness, a significant proportion (39.9%) remained unsure. Table 4: Knowledge of eye diseases of the participants I don't know No Yes     N % N % N % Information about cataract Does it cause blindness? 295 50.9% 82 14.2% 202 34.9% Can it be avoided? 298 51.5% 53 9.2% 228 39.4% Can it be treated? 225 38.9% 16 2.8% 338 58.4% Do you think that your vision will return to what it was after treatment? 295 50.9% 101 17.4% 183 31.6% Information about glaucoma Does it cause blindness? 292 50.4% 41 7.1% 246 42.5% Can it be avoided? 320 55.3% 58 10.0% 201 34.7% Can it be treated? 277 47.8% 41 7.1% 261 45.1% Do you think that your vision will return to what it was after treatment? 344 59.4% 114 19.7% 121 20.9% Information about diabetic retinopathy Does it cause blindness? 339 58.5% 53 9.2% 187 32.3% Can it be avoided? 322 55.6% 38 6.6% 219 37.8% Can it be treated? 347 59.9% 47 8.1% 185 32.0% Do you think that your vision will return to what it was after treatment? 380 65.6% 121 20.9% 78 13.5% Information about dry eye Does it cause blindness? 231 39.9% 295 50.9% 53 9.2% Can it be avoided? 160 27.6% 31 5.4% 388 67.0% Can it be treated? 154 26.6% 27 4.7% 398 68.7% Do you think your vision will return to what it was after treatment? 198 34.2% 28 4.8% 353 61.0% E. Factors Associated with Knowledge of Eye Diseases Tables 5 and 6 display associations between participants’ knowledge of specific eye diseases (cataract, glaucoma, diabetic retinopathy, and dry eye) and various sociodemographic characteristics and family history of the respective diseases. Statistically significant associations were observed for certain factors. In Table 5, knowledge of cataract and glaucoma was significantly associated with academic year and college, where medical students displayed higher awareness (p < 0.001). Family history of cataract was also linked to better knowledge (p < 0.001). However, family history of glaucoma did not have a significant impact on knowledge levels (p = 0.132). Table 5: Association of knowledge of cataract and glaucoma with sociodemographic characteristics and family history of respective disease Cataract Information P value{u/K} Glaucoma information P value{u/K}     M SD   M SD   Sex Female 1.60 1.30 0.532 1.50 1.33 0.275 Male 1.67 1.45   1.39 1.46 Academic year Graduate 1.81 1.37 0.011* 1.65 1.36 0.001* 5th Year 2.03 1.22   2.18 1.29 4th Year 1.98 1.38   1.85 1.39 6th Year 2.09 1.57   2.09 1.61 1st Year 1.44 1.42   1.00 1.37 2nd Year 1.50 1.26   1.42 1.38 3rd Year 1.49 1.47   1.21 1.34 College Medical 2.00 1.36 0.001* 1.97 1.39 0.001* Non- medical 1.29 1.35   .90 1.23 Any family member with cataract No 1.54 1.40 0.001* 1.43 1.43 - Yes 2.38 1.18   1.46 1.35 Any family member with glaucoma No 1.63 1.40 - 1.41 1.42 0.132 Yes 1.88 1.37   1.76 1.33 Kindependent samples Kruskal-Wallis test uindependent samples Mann-Whitney U Test *p0.05, Significant In Table 6, for knowledge of diabetic retinopathy and dry eye, significant associations were observed with academic year, college, and family history. Graduates and medical students demonstrated higher knowledge levels (p < 0.001). Family history positively influenced knowledge, with p-values less than 0.001. Table 6: Association of knowledge of diabetic retinopathy and dry eye with sociodemographic characteristics and family history of respective disease Diabetic retinopathy information P value{u/K} Dry eye information P value{u/K}     M SD   M SD   Sex Female 1.10 1.27 0.723 2.38 1.13 0.001* Male 1.18 1.39   1.88 1.40 Academic year Graduate 1.39 1.39 0.001* 2.08 1.29 0.022* 5th Year 1.76 1.26   2.38 1.07 4th Year 1.61 1.37   2.41 1.17 6th Year 1.88 1.36   2.28 1.28 1st Year .82 1.28   1.82 1.42 2nd Year .92 1.22   2.20 1.32 3rd Year 1.01 1.32   1.90 1.37 College Medical 1.52 1.37 0.001* 2.34 1.19 0.001* Non- medical .79 1.22   1.78 1.41 Yes 1.18 1.34   2.29 1.34 Any family member with diabetic retinopathy No 1.12 1.35 0.001* 2.03 1.34 - Yes 2.15 .99   3.00 .56 Any family member with dry eye No 1.21 1.38 - 1.91 1.40 0.001* Yes 1.01 1.25   2.45 1.05 Kindependent samples Kruskal-Wallis test uindependent samples Mann-Whitney U test *p0.05, Significant

Our study aimed to assess the level of awareness of common eye diseases among college students, both medical and non-medical, and to evaluate their knowledge while exploring existing misconceptions regarding eye diseases. Study findings demonstrated a need for improved awareness and education regarding common eye diseases among college students. The relatively low levels of knowledge, particularly among non-medical students, suggest that many students may need help comprehending the potential consequences of these eye conditions. This lack of awareness could have severe implications for their future eye health. Only 58.4% of participants recognized cataract as a treatable condition is a cause for concern. Cataract is one of the most common eye disorders, and timely treatment can prevent severe visual impairment [10]. The uncertainty regarding whether cataract causes blindness underscores the need for more apparent education on this matter [11]. Age was widely recognized as a risk factor for Cataracts by the majority of participants. Family history and the influence of physical diseases were also identified. These findings align with the well-established risk factors for cataracts, demonstrating a basic understanding among the participants [12]. Glaucoma association with blindness was acknowledged by 42.5% of students, which suggests some understanding of its severity [13]. However, only 45.1% were aware that it is treatable. Given that glaucoma is often asymptomatic until advanced stages, it is crucial for students to understand the importance of regular eye check-ups and early intervention [14]. Acknowledging age and family history as risk factors for glaucoma was prominent. Participants also recognized physical diseases like high blood pressure and diabetes. These findings indicate a reasonable awareness of the multifaceted risk factors associated with glaucoma, which is also consistent with the previous studies [15]. There is a common misconception about diabetic retinopathy, with 65.6% of participants believing that vision can return to normal after treatment. This finding highlights the need to clarify the realistic outcomes of treatment and emphasize the role of prevention in managing this diabetes- related eye condition [16]. A substantial proportion recognized physical diseases like high blood pressure and diabetes as risk factors for diabetic retinopathy [17]. Family history and age were also acknowledged. These findings reflect a basic understanding of the association between systemic health conditions and diabetic retinopathy. While most students recognize that dry eye is treatable and can be avoided, a significant proportion remained unsure if it causes blindness. This uncertainty underscores the importance of education to differentiate between treatable discomfort and severe vision impairment [18]. Age and family history were acknowledged as potential risk factors. Additionally, the influence of medications and physical diseases like high blood pressure and diabetes were recognized. The diversity of risk factors suggests a need for further education on this condition [19]. Awareness about eye diseases among the participants varied. Dry eye had the highest awareness level, followed by cataract and glaucoma. This underscores the need for improved knowledge dissemination among college students to raise awareness about common eye conditions. The sources of information regarding eye diseases were diverse. The internet emerged as the most significant source, followed by family, friends, and relatives. The statistically significant associations between knowledge of eye diseases and academic year and college suggest that the curriculum in medical colleges is more effective in imparting knowledge about eye conditions. This finding highlights the potential for incorporating eye health education into the extracurricular campaigns]. Family history of cataract positively influenced knowledge of participants. This underscores the role of family in raising awareness and suggests that family medical histories should be used as an educational tool [21]. Conversely, the family history of glaucoma did not significantly impact knowledge. This result indicates that more targeted efforts are required to educate students about the familial risks associated with glaucoma [22].

Educational programs should be tailored to address the specific knowledge gaps and misconceptions identified in this study. This includes clarifying risk factors for eye diseases and enhancing awareness of conditions like glaucoma and diabetic retinopathy. Academic institutions should consider integrating eye health topics into their curricula, particularly in non- medical colleges. This integration can include lectures, workshops, or awareness campaigns to ensure students receive essential eye health education. It is crucial to address misconceptions about eye diseases, such as the belief that vision always returns to normal after treatment. Clear and accurate information should be provided to ensure that students have a realistic understanding of these conditions. Family medical histories can be utilized as a tool to enhance awareness. Encouraging students to discuss their family medical backgrounds and understand the genetic risks associated with eye diseases can be an effective strategy. Emphasis should be placed on early detection and prevention of eye diseases. Regular eye check-ups and healthy eye habits should be promoted to reduce the incidence of these conditions.

It is important to acknowledge certain limitations. The research sample primarily consists of college students, which may only fully represent the entire population. The data relies on self-reported information, which can introduce response bias. The research was conducted at a specific university, so the findings might only universally apply to some colleges and universities in Saudi Arabia.

A significant proportion of participants exhibited awareness of conditions like dry eye, cataract, and glaucoma; there is room for improvement, as a substantial number remained unaware of these diseases. Study findings underscore the importance of educational interventions to enhance awareness, especially for students in non-medical disciplines. It also highlights the influence of family history on knowledge levels and emphasizes the role of various sources of information, including the Internet and educational channels. These insights can inform targeted eye health education programs for college students.

The authors declare no conflict of interest. All authors read and approved the final version of the paper.

All authors contributed equally in this paper.