BACKGROUND/PURPOSE: To evaluate the relationship between refractive error and vision-related quality of life in 16-year-old students in Taiwan. METHODS: A cross-sectional study was designed for 16-year junior-high-school students in Taiwan. Myopia was defined as a spherical refractive error (SRE) < -0.50 D, hyperopia as SRE > +1.0 D, and emmetropia as SRE -0.5-+1.0 D in the better eye. Vision-related quality of life was assessed using the Taiwan Chinese version of the 25-Item National Eye Institute Visual Functioning Questionnaire. RESULTS: Of the 688 participants, 466 (68%) had myopia and 22 (3%) had hyperopia. In logistic-regression models adjusted for gender, parents' education, family income, and parental refractive error, myopia was an independent risk factor of poorer vision-related quality of life for both near vision (odds ratio 1.73, 95% confidence interval 1.22-2.45) and distance vision (odds ratio 3.11, 95% confidence interval 2.23-4.35). Hyperopia was not associated with near- or distance-vision difficulty. CONCLUSION: In this study population, myopia was associated with difficulties in near and distance vision compared to emmetropia. Further studies are needed to confirm our findings in other populations.