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Updated: Jan 17, 2026

Binocular Dynamic Visual Acuity in Eyeglass-Corrected Myopic Patients
Published on: March 29, 2022
Uncorrected refractive errors, visual impairment and need for spectacles among children and adolescents in eastern,
Yue Zhou1, Qi Cai1, Xiaojuan Chen1
1Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China.
Insights
Uncorrected refractive errors (URE) and the need for spectacles are high in Chinese youth, despite low visual impairment (VI) rates. Myopia is a key risk factor, highlighting the need for targeted interventions to prevent vision loss.
Area of Science:
- Ophthalmology
- Public Health
- Pediatrics
Background:
- Uncorrected refractive errors (URE) are a leading cause of preventable visual impairment (VI) in children globally.
- China faces high myopia prevalence and insufficient spectacle coverage among youth.
- Data on URE, VI, and spectacle needs in eastern China are scarce, especially concerning anisometropia.
Purpose of the Study:
- To evaluate the prevalence of URE, VI, and the need for spectacles in children and adolescents in Nantong, China.
- To identify risk factors associated with URE, VI, and spectacle needs, including anisometropia.
- To inform targeted interventions for preventing visual impairment.
Main Methods:
- A cross-sectional school-based study involving 9,438 participants aged 7-19 years in Nantong, China.
- Assessment of uncorrected visual acuity, presenting visual acuity (PVA), and best-corrected visual acuity.
- Non-cycloplegic autorefraction to define URE, VI, and spectacle needs.
Main Results:
- The prevalence of URE was 15.7%, VI was 4.9%, and the need for spectacles was 55.9%.
- Myopia, hyperopia, anisometropia, female sex, and older age were significant risk factors for URE and spectacle needs.
- Myopia and rural residence were associated with VI.
Conclusions:
- While VI prevalence was low, URE and spectacle needs were high among eastern Chinese youth.
- Myopia is the primary risk factor for URE, VI, and spectacle needs; anisometropia also plays a significant role.
- Intervention strategies require adjustment to eliminate preventable visual impairments.
Background:
Uncorrected refractive errors (URE) are the leading preventable cause of visual impairment (VI) in children globally, with China facing a critical dual challenge of high myopia prevalence and insufficient spectacle coverage among youth. Despite eastern China's rapid development, population-based data on URE, VI, and need for spectacles remain scarce, particularly regarding the understudied role of anisometropia and subtype-specific refractive risks. This study evaluates these unmet needs to inform targeted interventions.
Methods:
A cross-sectional school-based study was conducted in Nantong, China, including participants 7-19 years of age. All participants underwent assessments of their uncorrected visual acuity, presenting visual acuity (PVA), and best-corrected visual acuity. URE was defined as PVA worse than 0.3 logMAR (6/12 Snellen) with ≥1 line improvement (≥0.1 logMAR) after correction in either eye.VI was defined as PVA < 6/12 in the better eye. Need for spectacles was defined as the total prevalence of refractive error requiring correction, including unmet, under-met, and met needs. Non-cycloplegic autorefraction was assessed for each participant.
Results:
Of the 9,864 participants, 9,438 were included in the analysis. The total prevalence of URE, VI and need for spectacles was 15.7% (95% CI: 15.0-16.5; n = 1,485),4.9% (95% CI: 4.9-5.3; n = 459) and 55.9% (95% CI: 54.9-56.9; n = 5,275), respectively. Multivariate analysis showed that factors such as female sex (aOR: 1.24, 95% CI: 1.09-1.40), wearing spectacles (aOR: 0.16, 95% CI: 0.14-0.19), older age groups (e.g., aOR: 3.92 for 13-14 years), hyperopia (aOR: 13.08, 95% CI: 7.67-22.31), myopia (aOR: 18.65, 95% CI: 12.54-27.77), and anisometropia (aOR: 1.87, 95% CI: 1.64-2.12) were associated with URE. For VI, significant associations included female sex (aOR: 1.20, 95% CI: 0.98-1.47), hyperopia (aOR: 7.23, 95% CI: 1.60-32.61), myopia (aOR: 53.04, 95% CI: 19.68-142.95), and rural residence (aOR: 1.53, 95% CI: 1.25-1.87). Factors such as older age (highest aOR: 11.77 for 19 years), female sex (aOR: 1.58, 95% CI: 1.42-1.77), hyperopia (aOR: 16.56, 95% CI: 10.97-25.01), myopia (aOR: 28.88, 95% CI: 21.83-38.19), astigmatism (aOR: 2.50, 95% CI: 2.22-2.82), and anisometropia (aOR: 1.37, 95% CI: 1.21-1.55) were associated with need for spectacles.
Conclusion:
Although the prevalence of VI among children and adolescents in eastern China was low, the prevalence of URE and the need for spectacles were high. Myopia was the most important risk factor for URE, VI, and need for spectacles, and the impact of anisometropia on URE, VI, and need for spectacles cannot be ignored. Further research on adjusting intervention strategies is needed to eliminate preventable visual impairments.
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