ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Children and Health
Volume 13 - 2025 | doi: 10.3389/fped.2025.1596389
This article is part of the Research TopicChildren's Health and Screen TimeView all 13 articles
A study on the status of myopia and pre-myopia among primary school students in different regions of Shaanxi Province, China
Provisionally accepted
- 1xi’an central hospital, xi'an, China
- 2Xi’an Daxing Hospital, Xi’an, Shaanxi Province, China
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Objective: This 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.From 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.Results: Age-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.Our 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.
Keywords: Myopia epidemiology, pre-myopia, School-age children, geographic disparity, Refractive error, China
Received: 19 Mar 2025; Accepted: 28 May 2025.
Copyright: © 2025 Dong, Li, Liu, Zhang, Wang, Li and Du. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhaojiang Du, xi’an central hospital, xi'an, China
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