Prevalence and Coexistence of Multidomain Visual Findings in Primary-School Children in Madrid: A Single-School Cross-Sectional Study

To describe the prevalence and coexistence of visual findings across six domains in primary-school children and explore differences by sex and school grade. This single-school cross-sectional study included 579 children aged 6–12 years in Madrid, Spain. Of 994 schoolchildren, 581 underwent examination (58.5% participation). Accommodation and ocular motility findings were classified using monocular accommodative facility and original Double-H scores, respectively; other categories used recorded clinical diagnoses. A stricter motility criterion (scores 0–1), selected post hoc, was compared with an expanded criterion (scores 0–2). Prevalence estimates, exact combinations, and exploratory associations were examined. Among 577 children with complete classification data, 240 (41.6%; 95% confidence interval [CI], 37.6–45.7%) had at least one finding, and 52 (9.0%) had concurrent findings. Reduced accommodative facility affected 19.4%, ocular motility findings 11.4%, refractive correction status 9.8%, and vergence findings 9.2%. Accommodative facility differed by school grade, while accommodation and refractive findings differed by sex after adjustment for multiple comparisons. No pairwise association remained statistically significant after adjustment. The expanded motility criterion increased overall prevalence to 54.1%. Multidomain visual findings and their coexistence were observed, but estimates depended substantially on operational criteria. The single-school setting and 58.5% participation rate limit generalizability. These findings should not be interpreted as confirmed clinical disorders or treatment needs without further assessment.