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Originally published In Press as doi:10.1167/iovs.07-1160 on March 31, 2008
 (Investigative Ophthalmology and Visual Science. 2008;49:2888-2894.)
© 2008 by The Association for Research in Vision and Ophthalmology, Inc.
DOI:  10.1167/iovs.07-1160
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Visual Disability, Visual Function, and Myopia among Rural Chinese Secondary School Children: The Xichang Pediatric Refractive Error Study (X-PRES)—Report 1

Nathan Congdon,1,2 Yunfei Wang,1 Yue Song,1 Kai Choi,3 Mingzhi Zhang,1 Zhongxia Zhou,1 Zhenling Xie,1 Liping Li,4 Xueyu Liu,4 Abhishek Sharma,2,5 Bin Wu,6 and Dennis S. C. Lam1,2

1From the Joint Shantou International Eye Center, Shantou University and Chinese University of Hong Kong, Shantou, Peoples Republic of China; the 2Department of Ophthalmology and Visual Science, Chinese University of Hong Kong, Hong Kong SAR, Peoples Republic of China; the 3Centre for Epidemiology and Biostatistics, Chinese University of Hong Kong School of Public Health, Hong Kong SAR, Peoples Republic of China; the 4Shantou University School of Public Health, Shantou, Peoples Republic of China; 5Department of Public Health, Oxford University, Oxford, United Kingdom; and the 6Xichang Eye Center, Xichang, Peoples Republic of China.

PURPOSE. To evaluate visual acuity, visual function, and prevalence of refractive error among Chinese secondary-school children in a cross-sectional school-based study.

METHODS. Uncorrected, 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.

RESULTS. Among 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 (≤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).

CONCLUSIONS. Visual 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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