• Nathan Congdon, Yunfei Wang, Yue Song, Kai Choi, Mingzhi Zhang, Zhongxia Zhou, Zhenling Xie, Liping Li, Xueyu Liu, Abhishek Sharma, Bin Wu, and Dennis S C Lam.
• Joint Shantou International Eye Center, Shantou University and Chinese University of Hong Kong, Shantou, Peoples Republic of China. ncongdon@cuhk.edu.hk
• Invest. Ophthalmol. Vis. Sci. 2008 Jul 1; 49 (7): 2888-94.

PurposeTo evaluate visual acuity, visual function, and prevalence of refractive error among Chinese secondary-school children in a cross-sectional school-based study.MethodsUncorrected, presenting, and best corrected visual acuity, cycloplegic autorefraction with refinement, and self-reported visual function were assessed in a random, cluster sample of rural secondary school students in Xichang, China.ResultsAmong the 1892 subjects (97.3% of the consenting children, 84.7% of the total sample), mean age was 14.7 +/- 0.8 years, 51.2% were female, and 26.4% were wearing glasses. The proportion of children with uncorrected, presenting, and corrected visual disability (< or = 6/12 in the better eye) was 41.2%, 19.3%, and 0.5%, respectively. Myopia < -0.5, < -2.0, and < -6.0 D in both eyes was present in 62.3%, 31.1%, and 1.9% of the subjects, respectively. Among the children with visual disability when tested without correction, 98.7% was due to refractive error, while only 53.8% (414/770) of these children had appropriate correction. The girls had significantly (P < 0.001) more presenting visual disability and myopia < -2.0 D than did the boys. More myopic refractive error was associated with worse self-reported visual function (ANOVA trend test, P < 0.001).ConclusionsVisual disability in this population was common, highly correctable, and frequently uncorrected. The impact of refractive error on self-reported visual function was significant. Strategies and studies to understand and remove barriers to spectacle wear are needed.

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