Int J Med Sci 2010; 7(6):342-353. doi:10.7150/ijms.7.342

Research Paper

Refractive Status and Prevalence of Refractive Errors in Suburban School-age Children

Lian-Hong Pi1, Lin Chen1, Qin Liu1, Ning Ke1, Jing Fang1, Shu Zhang1, Jun Xiao1, Wei-Jiang Ye1, Yan Xiong1, Hui Shi1, Zheng-Qin Yin2

1. Department of Ophthalmology, Children's Hospital, Chongqing Medical University, Chongqing, People's Republic of China
2. Southwest Hospital, Southwest Eye Hospital, The Third Military Medical University, Chongqing, People's Republic of China

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Pi LH, Chen L, Liu Q, Ke N, Fang J, Zhang S, Xiao J, Ye WJ, Xiong Y, Shi H, Yin ZQ. Refractive Status and Prevalence of Refractive Errors in Suburban School-age Children. Int J Med Sci 2010; 7(6):342-353. doi:10.7150/ijms.7.342. Available from

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Objective: This study investigated the distribution pattern of refractive status and prevalence of refractive errors in school-age children in Western China to determine the possible environmental factors. Methods: A random sampling strategy in geographically defined clusters was used to identify children aged 6-15 years in Yongchuan, a socio-economically representative area in Western China. We carried out a door-to-door survey and actual eye examinations, including visual acuity measurements, stereopsis examination, anterior segment and eyeball movements, fundus examinations, and cycloplegic retinoscopy with 1% cyclopentolate. Results: A total of 3469 children living in 2552 households were selected, and 3070 were examined. The distributions of refractive status were positively-skewed for 6-8-year-olds, and negatively-skewed for 9-12 and 13-15-year-olds. The prevalence of hyperopia (≥+2.00 D spherical equivalent [SE]), myopia (≤-0.50 D SE), and astigmatism (≥1.00 diopter of cylinder [DC]) were 3.26%, 13.75%, and 3.75%, respectively. As children's ages increased, the prevalence rate of hyperopia decreased (P<0.001) and that of myopia increased significantly (P<0.001). Children in academically challenging schools had a higher risk of myopia (P<0.001) and astigmatism (≥1.00DC, P =0.04) than those in regular schools. Conclusion: The distribution of refractive status changes gradually from positively-skewed to negatively-skewed distributions as age increases, with 9-year-old being the critical age for the changes. Environmental factors and study intensity influence the occurrence and development of myopia.

Keywords: refractive error, suburban school-age children, myopia