A study on the status of myopia and pre-myopia among primary school students in different regions of Shaanxi Province, China

ObjectiveThis cross-sectional study aimed to investigate the geographic disparities in myopia and pre-myopia prevalence among elementary school students across three distinct regions of Shaanxi Province (southern Hanzhong, Guanzhong, and northern Yulin) to inform region-specific myopia control strat...

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Main Authors: Dong Wei, Li Yangbing, Liu Chengfei, Zhang Ye, Wang Zihao, Li Yanying, He Xiaokang, Fu Kunlin, Du Zhaojiang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1596389/full
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author Dong Wei
Dong Wei
Li Yangbing
Liu Chengfei
Liu Chengfei
Zhang Ye
Zhang Ye
Wang Zihao
Wang Zihao
Li Yanying
Li Yanying
He Xiaokang
He Xiaokang
Fu Kunlin
Du Zhaojiang
author_facet Dong Wei
Dong Wei
Li Yangbing
Liu Chengfei
Liu Chengfei
Zhang Ye
Zhang Ye
Wang Zihao
Wang Zihao
Li Yanying
Li Yanying
He Xiaokang
He Xiaokang
Fu Kunlin
Du Zhaojiang
author_sort Dong Wei
collection DOAJ
description ObjectiveThis cross-sectional study aimed to investigate the geographic disparities in myopia and pre-myopia prevalence among elementary school students across three distinct regions of Shaanxi Province (southern Hanzhong, Guanzhong, and northern Yulin) to inform region-specific myopia control strategies.MethodsFrom March to May 2024, we employed multistage cluster sampling to recruit 8,207 eligible students (2,724 southern Shaanxi, 2,761 Guanzhong, 2,722 northern Shaanxi) from 12 randomly selected primary schools. Comprehensive ophthalmic examinations including uncorrected visual acuity and non-cycloplegic autorefraction were conducted. Continuous variables were expressed as mean ± standard deviation, while categorical variables were analyzed using chi-square tests.ResultsAge-standardized myopia prevalence was highest in northern Shaanxi (48.02%), followed by central Shaanxi/Guanzhong (42.96%) and southern Shaanxi (30.43%). Gender disparities persisted across all regions, with female students exhibiting significantly elevated myopia rates (southern Shaanxi: 34.00% vs. 26.91%; Guanzhong: 48.02% vs. 37.99%; northern Shaanxi: 52.54% vs. 44.13%; P < 0.05 for all comparisons). Pre-myopia prevalence displayed an inverse geographic pattern (southern Shaanxi: 40.60% > Guanzhong: 34.19% > northern Shaanxi: 33.73%; χ2 = 185.3, P < 0.001), with male students consistently showing higher pre-myopia detection rates than females (southern Shaanxi: 42.45% vs. 38.73%; Guanzhong 38.28% vs. 30.01%; northern Shaanxi: 37.64% vs. 29.17%; P < 0.05). A marked grade-level progression was observed, with myopia prevalence increasing annually while pre-myopia rates declined significantly.ConclusionOur findings reveal a north–south gradient in ocular health outcomes, with northern Shaanxi demonstrating concerningly high myopia prevalence coupled with reduced pre-myopia detection rates. The persistent female predominance in myopia burden and early detection gaps underscores the need for gender-sensitive interventions. The observed progression patterns suggest critical windows for prevention, advocating for: (1) Preschool-initiated vision protection programs, (2) Establishment of digital refractive registries for high-risk cohorts, and (3) Implementation of regionally tailored myopia control protocols prioritizing northern districts.
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spelling doaj-art-e41a7ef74c324483be2ef2b4e0ef10892025-08-20T02:33:00ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-06-011310.3389/fped.2025.15963891596389A study on the status of myopia and pre-myopia among primary school students in different regions of Shaanxi Province, ChinaDong Wei0Dong Wei1Li Yangbing2Liu Chengfei3Liu Chengfei4Zhang Ye5Zhang Ye6Wang Zihao7Wang Zihao8Li Yanying9Li Yanying10He Xiaokang11He Xiaokang12Fu Kunlin13Du Zhaojiang14Department of Ophthalmology, Xi'an Central Hospital, Xi'an, ChinaDepartment of Clinical Medicine, Yan'an University, Yan'an, Shaanxi, ChinaDepartment of Urology, Xi'an Daxing Hospital, Xi'an, Shaanxi, ChinaDepartment of Ophthalmology, Xi'an Central Hospital, Xi'an, ChinaDepartment of Clinical Medicine, Yan'an University, Yan'an, Shaanxi, ChinaDepartment of Ophthalmology, Xi'an Central Hospital, Xi'an, ChinaDepartment of Clinical Medicine, Yan'an University, Yan'an, Shaanxi, ChinaDepartment of Ophthalmology, Xi'an Central Hospital, Xi'an, ChinaDepartment of Clinical Medicine, Yan'an University, Yan'an, Shaanxi, ChinaDepartment of Ophthalmology, Xi'an Central Hospital, Xi'an, ChinaDepartment of Clinical Medicine, Yan'an University, Yan'an, Shaanxi, ChinaDepartment of Ophthalmology, Xi'an Central Hospital, Xi'an, ChinaDepartment of Clinical Medicine, Yan'an University, Yan'an, Shaanxi, ChinaDepartment of Ophthalmology, Maternal and Child Health Care Hospital of Dingbian County, Yulin, Shaanxi, ChinaDepartment of Ophthalmology, Xi'an Central Hospital, Xi'an, ChinaObjectiveThis cross-sectional study aimed to investigate the geographic disparities in myopia and pre-myopia prevalence among elementary school students across three distinct regions of Shaanxi Province (southern Hanzhong, Guanzhong, and northern Yulin) to inform region-specific myopia control strategies.MethodsFrom March to May 2024, we employed multistage cluster sampling to recruit 8,207 eligible students (2,724 southern Shaanxi, 2,761 Guanzhong, 2,722 northern Shaanxi) from 12 randomly selected primary schools. Comprehensive ophthalmic examinations including uncorrected visual acuity and non-cycloplegic autorefraction were conducted. Continuous variables were expressed as mean ± standard deviation, while categorical variables were analyzed using chi-square tests.ResultsAge-standardized myopia prevalence was highest in northern Shaanxi (48.02%), followed by central Shaanxi/Guanzhong (42.96%) and southern Shaanxi (30.43%). Gender disparities persisted across all regions, with female students exhibiting significantly elevated myopia rates (southern Shaanxi: 34.00% vs. 26.91%; Guanzhong: 48.02% vs. 37.99%; northern Shaanxi: 52.54% vs. 44.13%; P < 0.05 for all comparisons). Pre-myopia prevalence displayed an inverse geographic pattern (southern Shaanxi: 40.60% > Guanzhong: 34.19% > northern Shaanxi: 33.73%; χ2 = 185.3, P < 0.001), with male students consistently showing higher pre-myopia detection rates than females (southern Shaanxi: 42.45% vs. 38.73%; Guanzhong 38.28% vs. 30.01%; northern Shaanxi: 37.64% vs. 29.17%; P < 0.05). A marked grade-level progression was observed, with myopia prevalence increasing annually while pre-myopia rates declined significantly.ConclusionOur findings reveal a north–south gradient in ocular health outcomes, with northern Shaanxi demonstrating concerningly high myopia prevalence coupled with reduced pre-myopia detection rates. The persistent female predominance in myopia burden and early detection gaps underscores the need for gender-sensitive interventions. The observed progression patterns suggest critical windows for prevention, advocating for: (1) Preschool-initiated vision protection programs, (2) Establishment of digital refractive registries for high-risk cohorts, and (3) Implementation of regionally tailored myopia control protocols prioritizing northern districts.https://www.frontiersin.org/articles/10.3389/fped.2025.1596389/fullmyopia epidemiologypre-myopiaschool-age childrengeographic disparityrefractive errorChina
spellingShingle Dong Wei
Dong Wei
Li Yangbing
Liu Chengfei
Liu Chengfei
Zhang Ye
Zhang Ye
Wang Zihao
Wang Zihao
Li Yanying
Li Yanying
He Xiaokang
He Xiaokang
Fu Kunlin
Du Zhaojiang
A study on the status of myopia and pre-myopia among primary school students in different regions of Shaanxi Province, China
Frontiers in Pediatrics
myopia epidemiology
pre-myopia
school-age children
geographic disparity
refractive error
China
title A study on the status of myopia and pre-myopia among primary school students in different regions of Shaanxi Province, China
title_full A study on the status of myopia and pre-myopia among primary school students in different regions of Shaanxi Province, China
title_fullStr A study on the status of myopia and pre-myopia among primary school students in different regions of Shaanxi Province, China
title_full_unstemmed A study on the status of myopia and pre-myopia among primary school students in different regions of Shaanxi Province, China
title_short A study on the status of myopia and pre-myopia among primary school students in different regions of Shaanxi Province, China
title_sort study on the status of myopia and pre myopia among primary school students in different regions of shaanxi province china
topic myopia epidemiology
pre-myopia
school-age children
geographic disparity
refractive error
China
url https://www.frontiersin.org/articles/10.3389/fped.2025.1596389/full
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