Shaping the Future: University Students’ Insights on Enhancing Preventive Eye Health Education for Parents and Teachers

Childhood visual impairment is an increasingly recognized public health concern worldwide, including in Saudi Arabia, where uncorrected refractive errors, amblyopia and other preventable eye conditions contribute to long-term visual disability. Early detection and timely intervention are crucial in mitigating these issues, highlighting the need for effective preventive strategies that focus on awareness, screening and proactive eye care measures. Given that children spend a significant portion of their time under the supervision of parents and teachers, these caregivers play a central role in identifying early signs of visual problems, ensuring timely medical consultations and reinforcing healthy visual habits. However, a lack of knowledge and awareness among parents and educators often leads to missed opportunities for early diagnosis and intervention. Empowering parents and teachers with accurate information on preventive eye health can significantly enhance their ability to safeguard children’s vision.

University students, particularly those pursuing careers in health sciences, represent a valuable yet underutilized resource in strengthening community-based eye health education. Their academic background, combined with their potential role as future healthcare professionals, positions them as effective advocates for disseminating crucial eye health information to parents and teachers.

By understanding university students' perspectives on how preventive eye health education can be enhanced, targeted interventions can be developed to bridge existing knowledge gaps and improve awareness at the community level. Incorporating their insights can lead to innovative, accessible and culturally appropriate educational strategies that promote early detection and prevention of childhood visual impairment. Ultimately, such efforts can contribute to reducing the burden of avoidable visual impairment and fostering a society that prioritizes children's eye health.

Eye health is crucial for a child's overall development and early detection of vision problems can prevent lifelong impairment and its long-term consequences [1-2]. Parents and teachers play a crucial role in preventing eye diseases in children and raising their awareness of early signs and preventive measures ensure timely intervention [3-4]. There has been a significant increase in the prevalence of pediatric eye diseases worldwide, driven by a combination of factors such as rising screen time, genetic predisposition, environmental influences and a lack of early detection and preventive measures [5-7].

Studies show that in Saudi Arabia up to 20% of school-aged children suffer from refractive errors, many of which go undiagnosed [8-10]. This highlights the need for targeted preventive eye health education for parents and teachers, who often first notice changes in a child’s vision [11-14]. Culturally, family plays a central role in health decisions, with norms emphasizing the responsibility of the family for children's well-being. Therefore, involving parents in health education initiatives is essential. Understanding local cultural values is critical for developing effective strategies [15-16].

University students, especially those in health and education fields, are well-positioned to promote eye health education by bridging academic knowledge with community needs. Research highlights that culturally sensitive, community-driven programs are most effective in public health initiatives [17-18]. Understanding students' perspectives on preventive eye health education is essential for developing strategies that effectively engage parents and teachers. However, challenges such as the need for adequate training, institutional support and potential resistance from parents or educators must be addressed. Collaboration among students, educators and health professionals is crucial for establishing sustainable and impactful programs.

The current study aims to explore university students' perspectives on the importance, challenges and approaches to preventive eye health education for parents and teachers.

Study Setting and Design

From September 15, 2024 to January 15, 2025, this cross- sectional descriptive survey was conducted among Northern Border University students in Arar city of Saudi Arabia.

Sample Size and Sampling Method

Convenient sampling technique was employed and the minimal sample size for the study (386) was calculated according to the equation:

where, "Z₁-∞/2 = is the standard normal variate at 5% type 1 error (p<0.05); it is 1.96, p = the expected proportion based on previous studies, d = the absolute error (0.05), the expected proportion was considered 50% since there is no previous study in the Northern, Border region and to maximize the sample size."

Research Tool

The level of awareness was assessed using a predesigned bilingual questionnaire (Arabic and English), which included an introduction section followed by a demographics section. Awareness of preventive eye health and perspectives on current education efforts were assessed through five questions in each section. The final section comprised four questions focusing on improvement suggestions. The questionnaire was distributed online via platforms such as Google Forms and university portals, as well as in-person at university campuses.

Inclusion and Exclusion Criteria

Both genders who are 18 years and above and are studying at a university were included. Individuals who live outside the study area and who are mentally challenged were excluded

Statistical Analysis

STATA/SE version 11.2 for Windows (STATA Corporation, College Station, Texas) was used for data management and analysis. The data were described in terms of frequency and percentage regarding categorical data and Mean±Standard Deviation (SD) regarding quantitative data. Shapiro-Wilk W test was used to examine the distribution of knowledge scores. Comparisons of students’ knowledge levels between the different study groups were carried out using the Kruskal Wallis test (χ²) and the Mann-Whitney Test (Z), as appropriate. Statistical significance was considered at p<0.05.

Ethical Approval

Ethical approval number 104/24/H for this project was issued by the Local Committee of Bioethics of Northern Border University.

A total of 482 university students participated, with the majority (62.86%) aged 18-22 years. Male students comprised 68.46% of the sample. Most students (59.96%) were from the College of Medicine and the largest group (24.27%) were in their fourth year (Table 1).

Over half (55.39%) had received formal education on eye health but only 41.49% had participated in related

Table 1: Demographic and Background Characteristics of the Studied Students (N = 482)

Table 2: Students' Awareness of Preventive Eye Health Education for Parents and Teachers in Saudi Arabia (N = 482)

Table 3: Relationship Between Students' Awareness of Preventive Eye Health Education for Parents and Teachers in Saudi Arabia and Their Age and Gender (N = 482)

P²: The Kruskal Wallis test statistic, z: The Mann-Whitney test statistic, Statistical significance was considered at p<0.05

activities. Awareness of common pediatric eye conditions varied, with 29.25% being very aware, while 11.62% had no awareness. Most students (67.01%) strongly supported preventive eye health education for parents and teachers, yet only 34.85% felt their curriculum adequately covered the topic (Table 2).

Awareness significantly differed by age (p = 0.02), with students aged 23-27 scoring highest (3.46±1.39). Gender differences were also significant (p = 0.002), with males scoring higher (3.31±1.45) than females (2.85±1.46) (Table 3, Figure 1 and 2).

About 32.37% considered current initiatives very effective, while 20.75% found them ineffective. Barriers included lack of awareness (59.13%), limited information access (42.95%), cultural factors (31.95%) and insufficient resources (30.29%). Key suggested topics for education

Table 4: Students’ Perspectives on Current Educational Efforts to Enhance Preventive Eye Health Among Parents and Teachers in Saudi Arabia (N = 482)

*More than one answer was allowed

Figure 1: Comparison of Students' Awareness of Preventive Eye Health Education for Parents and Teachers in Saudi Arabia by Age (N = 482)

included common eye conditions (60.99%), early detection (57.68%), regular exams (51.04%), digital device use (41.49%) and eye-healthy diets (27.80%). Most students (43.98%) strongly supported integrating eye health into school curricula and 46.06% were very willing to participate in educational programs (Table 4).

Proposed improvements included community programs (58.71%), school curriculum integration (48.34%), workshops (45.23%), digital platforms (41.91%) and volunteer initiatives (30.70%) (Table 5).

Figure 2: Comparison of Students' Awareness of Preventive Eye Health Education for Parents and Teachers in Saudi Arabia by Gender (N = 482)

Demographic Characteristics of Participants

A total of 482 university students participated in this study, representing a diverse sample. The majority (62.86%) were aged between 18-22 years, with a predominance of male students (68.46%). This gender distribution may reflect the demographics of the university and participation trends in health-related research. Most students were from the College of Medicine (59.96%), with the largest group (24.27%) in their fourth year of study. Their higher representation could

Table 5: Students’ Suggestions for Improving Preventive Eye Health Education for Parents and Teachers in Saudi Arabia (N = 482)

*More than one answer was allowed

suggest increased engagement in academic initiatives and surveys at this stage of their education. Consistent with our findings, higher male participation in preventive health programs has been observed in Saudi Arabia [19]. In contrast, studies from Turkey [20] and Sweden [21] report greater female participation, highlighting geographical and educational differences that may influence engagement in health awareness programs.

Awareness of Preventive Eye Health Education

More than half of the participants (55.39%) reported receiving formal education or training in eye health. However, despite this exposure, only 41.49% had actively participated in related activities, suggesting a disconnect between theoretical knowledge and practical application. This gap underscores the need for more interactive engagement strategies to ensure students apply their knowledge in real-world settings.

Perception of Common Eye Health Issues in Children

The level of awareness regarding common childhood eye health issues varied among students. While 29.25% reported high awareness, 34.23% indicated moderate awareness. Encouragingly, a majority (67.01%) strongly agreed on the importance of preventive eye health education for parents and teachers. However, only 34.85% felt that their university curriculum adequately covered the topic, revealing a significant discrepancy between the perceived importance of eye health education and its academic representation. This suggests the need for curriculum enhancements that integrate preventive eye care more comprehensively.

Influence of Age and Gender on Awareness

The study found significant associations between students’ awareness levels and their age and gender. Older students (aged 23-27 years) exhibited higher awareness levels, with a mean knowledge score of 3.46±1.39, compared to younger students (aged 18-22 years). This trend may reflect increased academic exposure to eye health topics over time. Additionally, male students had significantly higher knowledge scores than female students (3.31±1.45 vs. 2.85±1.46), warranting further exploration into gender-specific factors that influence awareness. Cultural, educational and social influences may contribute to these differences, emphasizing the need for targeted interventions to address potential disparities.

Effectiveness of Existing Eye Health Education Initiatives

Student opinions on the effectiveness of current eye health education initiatives for parents and teachers were mixed. While 32.37% found these initiatives very effective, 23.65% rated them as neutral or ineffective. This finding suggests that while some programs are beneficial, others may lack accessibility, engagement or relevance. Improving the structure and outreach of these initiatives is crucial to ensuring their effectiveness in raising awareness and fostering preventive eye health practices.

Barriers to Effective Preventive Eye Health Education

Several barriers to effective eye health education were identified, including lack of awareness (59.13%), limited access to information (42.95%) and cultural factors (31.95%). These findings highlight critical obstacles that hinder widespread implementation of educational programs. Addressing these challenges requires targeted interventions, such as improving accessibility to educational resources, tackling cultural stigmas and promoting community-wide understanding of eye health.

Strategies to Enhance Preventive Eye Health Education

Students proposed various strategies to improve preventive eye health education. The most favored approaches included integrating eye health topics into school curricula (43.98%) and developing community-based educational programs (58.71%). These findings reinforce the importance of embedding eye health education within broader public health initiatives.

Additionally, students showed strong interest in utilizing technology for eye health education. A significant proportion (43.57%) viewed digital tools as essential, with mobile health applications (52.49%) and online educational sessions (41.49%) being the preferred platforms. These insights suggest that leveraging digital resources could enhance the accessibility and reach of eye health education programs, particularly among parents and teachers.

This study highlights a significant gap in preventive eye health education among university students, particularly in terms of formal training, participation in related activities and integration into the academic curriculum. While most students recognize the importance of eye health education for parents and teachers, there is a clear need for more comprehensive coverage of eye health topics in university curricula. Furthermore, the findings suggest that increasing awareness, overcoming barriers such as limited access to information and leveraging technology could enhance the effectiveness of preventive eye health education. Addressing these issues will be crucial in promoting better eye health practices and ensuring that students are well-equipped to educate others, particularly in school and community settings. The study also calls for future research to explore the impact of current educational initiatives and to develop strategies for more targeted and effective eye health programs.

Strengths

The study provides valuable insights into university students' awareness of preventive eye health education, highlighting key areas for curriculum development and community engagement. The inclusion of demographic factors such as age and gender enables a nuanced understanding of how these variables influence awareness and perceptions of eye health.

Limitations

The cross-sectional design limits the ability to draw causal conclusions and the reliance on self-reported data may introduce response bias, affecting the accuracy of the findings.

Acknowledgement

The authors extend their appreciation to the Deanship of Scientific Research at Northern Border University, Arar, Saudi Arabia for funding this research work through the project number “NBU- FFR-2025-1301-03”.

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