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Effective refractive error coverage and vision impairment among schoolchildren in Xinjiang, China

Fangfang Lu1, Hongwen Jiang2, Waihang Wong1

  • 1State Key Laboratory of Ophthalmology; Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science; Guangdong Provincial Clinical Research Center for Ocular Disease, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China.

The British Journal of Ophthalmology
|May 12, 2026
PubMed

Insights

Uncorrected refractive error causes most vision impairment in Xinjiang schoolchildren. Effective refractive error coverage (eREC) is low, indicating a need for better eye care access and quality to meet global targets.

Area of Science:

  • Ophthalmology
  • Public Health
  • Pediatric Optometry

Background:

  • Uncorrected refractive error (URE) is the primary cause of vision impairment (VI).
  • Effective refractive error coverage (eREC) is a key indicator for global eyecare progress.
  • Data on eREC in children is scarce, necessitating regional estimates.

Purpose of the Study:

  • To estimate eREC and VI prevalence among schoolchildren in Xinjiang, China.
  • To assess the gap in refractive correction services for children.
  • To identify factors associated with eREC and refractive error coverage (REC).

Main Methods:

  • A population-based, cross-sectional study of 3306 schoolchildren aged 7-20 years in Xinjiang.
  • Visual acuity measured using standard charts; eREC, REC, and Quality Gap calculated per WHO definitions.
  • Multivariable logistic regression analyzed sociodemographic correlates of eREC and REC.

Main Results:

  • VI prevalence was 8.74% (uncorrected), 4.30% (presenting), and 0.15% (best-corrected).
  • Overall eREC was 51.76% and REC was 54.93%, with a 5.77% quality gap.
  • Secondary school education correlated with higher eREC (OR=3.59).

Conclusions:

  • Uncorrected refractive error accounts for 96.51% of VI in this cohort.
  • The eREC in Xinjiang is significantly below the WHO 2030 target for China.
  • Urgent improvements in the accessibility and quality of refractive correction services are needed.
Abstract

Keywords:
effective refractive error coverageschoolchildrenvisual impairment

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