Prevalence of Refractive Error and Visual Acuity Among School Children in the Plateau Region of Qinghai, China

Abstract

Qiuxin Wu,1– 3,* Qingmei Tian,1– 3,* Xiuyan Zhang,1– 3,* Jing Xu,2 Guodong Tang,2 Runkuan Li,1 Xiaoxiao Guo,1 Zongqing Xu,1 Jiaojiao Feng,1 Jike Song,1– 4 Hongsheng Bi1– 4 1Shandong University of Traditional Chinese Medicine, Jinan, 250014, People’s Republic of China; 2Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, People’s Republic of China; 3Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, 250002, People’s Republic of China; 4Shandong Provincial Key Laboratory of Integrative Medicine for Eye Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Institute of Children Health and Myopia Prevention and Control, Jinan, 250002, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jike Song; Hongsheng Bi Tel [phone]Fax [phone]Email [email protected]; [email protected]: This study aimed to investigate the prevalence of refractive error and visual acuity among school children in the plateau region of Qinghai, China.Methods: The school-based, cross-sectional study was performed in Menyuan, Qinghai, China. Three kindergartens and three primary schools were randomly enrolled from both rural areas and county towns. The participants had undergone ophthalmic examinations of the intraocular pressure (IOP), uncorrected visual acuity (UCVA), presenting visual acuity (PVA) and best corrected visual acuity (BCVA), cycloplegic refraction, and axial length (AL). Regression analysis was applied to investigate the potential risk factors affecting the prevalence of various refractive errors.Results: A total of 3770 children were invited to participate, and 3524 (93.5%) had undergone examination. Among the 3524 children (51.8% boys) with a mean age of 8.3± 2.3 years, 1049 (29.8%) had myopia, 30 (0.9%) had high myopia, 1692 (48.0%) had mild hyperopia, 152 (4.3%) had medium to marked hyperopia and 925 (26.2%) had astigmatism. The mean SER was − 0.16± 1.86 D and decreased with age. The AL increased with age from 21.80± 0.59 mm at 4-years to 23.53± 1.05 mm at 12-years. The myopia prevalence increased with age from 2.0% at 4 years to 62.8% at 12-years. Myopia was associated with increasing age, county town habitation and girls. Among the 723 participants with PVA 20/40 or worse in one eye, 564 (78.0%) were due to uncorrected refractive error, and 83 (22.0%) were due to undercorrected refractive error. Among the 1049 children with myopia, only 254 wore glasses, and 151 children with PVA had a worse BCVA and did not have accurate spectacles.Conclusion: The prevalence of myopia is very high among school children in Menyuan. Only 24.2% of myopic children wore glasses, and 59.4% of children did not have accurate spectacles. Strategies to improve access to eye care and affordable glasses are needed.Keywords: school children, refractive error, myopia, plateau region, glass wear

Keywords

• school children
• refractive error
• myopia
• plateau region
• glass wear