Cross-sectional study of myopia prevalence and associated risk factors among children and adolescents in Shaanxi Province, China, in 2021

Myopia is a growing global health issue, particularly among Chinese children and adolescents. This study aimed to investigate the prevalence and risk factors of myopia among children and adolescents in Shaanxi Province, China. A cross-sectional study conducted in 2021 included 261,504 participants from Guanzhong, Southern Shaanxi, and Northern Shaanxi. Ophthalmological examinations were performed, and refractive error was assessed using non-cycloplegic refraction to determine the spherical equivalent (SE). Myopia was defined as SE ≤-0.5 D and categorized into low (SE >-3.0 D), moderate (SE >-6.0 D), and high myopia (SE ≤-6.0 D). Data on age, gender, education level, and ethnicity were collected using structured questionnaires administered through face-to-face interviews. The overall prevalence of myopia was 67.4% (95% CI: 67.20%-67.50%), with high myopia at 4.63% (95% CI: 4.55%-4.71%). Myopia was more common in females and increased with educational level, reaching 92.48% in senior high school students. Northern Shaanxi exhibited the highest prevalence of both myopia and high myopia. Regression analysis identified gender, education level, and region as significant risk factors. Myopia is highly prevalent among children and adolescents in Shaanxi Province, with notable gender, educational, and regional disparities. The findings underscore the urgent need for region-specific and education-level-targeted myopia prevention strategies.