Related Experiment Video
Updated: Jun 7, 2026
Subjective Refraction Test Using a Smartphone for Vision Screening
Published on: October 18, 2024
Refractive status and prevalence of refractive errors in suburban school-age children
Lian-Hong Pi1, Lin Chen, Qin Liu
1Department of Ophthalmology, Children's Hospital, Chongqing Medical University, Chongqing, People's Republic of China.
Insights
Refractive errors like myopia increase with age in Western Chinese children, with 9 years being a critical age. Environmental factors and academic pressure contribute to myopia and astigmatism prevalence.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Public Health
Background:
- Refractive status distribution and error prevalence in school-age children are crucial for understanding visual health.
- Western China presents a unique demographic for studying environmental influences on refractive development.
Purpose of the Study:
- To investigate refractive status patterns and refractive error prevalence in Western Chinese school-age children.
- To identify potential environmental factors associated with refractive errors.
Main Methods:
- A random cluster sampling strategy was employed for children aged 6-15 years in Yongchuan, Western China.
- Door-to-door surveys and comprehensive eye examinations, including cycloplegic retinoscopy, were conducted.
Main Results:
- Prevalence rates were 3.26% for hyperopia, 13.75% for myopia, and 3.75% for astigmatism.
- Hyperopia decreased and myopia increased significantly with age, with a shift in refractive status distribution around age 9.
- Children in academically demanding schools showed higher risks for myopia and astigmatism.
Conclusions:
- Refractive status distribution shifts from positive to negative skew with increasing age, with 9 years as a critical transition point.
- Environmental factors and academic intensity are significant influences on myopia development in children.
Objective:
This study investigated the distribution pattern of refractive status and prevalence of refractive errors in school-age children in Western China to determine the possible environmental factors.
Methods:
A random sampling strategy in geographically defined clusters was used to identify children aged 6-15 years in Yongchuan, a socio-economically representative area in Western China. We carried out a door-to-door survey and actual eye examinations, including visual acuity measurements, stereopsis examination, anterior segment and eyeball movements, fundus examinations, and cycloplegic retinoscopy with 1% cyclopentolate.
Results:
A total of 3469 children living in 2552 households were selected, and 3070 were examined. The distributions of refractive status were positively-skewed for 6-8-year-olds, and negatively-skewed for 9-12 and 13-15-year-olds. The prevalence of hyperopia (≥+2.00 D spherical equivalent [SE]), myopia (≤-0.50 D SE), and astigmatism (≥1.00 diopter of cylinder [DC]) were 3.26%, 13.75%, and 3.75%, respectively. As children's ages increased, the prevalence rate of hyperopia decreased (P<0.001) and that of myopia increased significantly (P<0.001). Children in academically challenging schools had a higher risk of myopia (P<0.001) and astigmatism (≥1.00DC, P =0.04) than those in regular schools.
Conclusion:
The distribution of refractive status changes gradually from positively-skewed to negatively-skewed distributions as age increases, with 9-year-old being the critical age for the changes. Environmental factors and study intensity influence the occurrence and development of myopia.
