Objective: To determine the prevalence and causes of visual impairment, and spectacle uses among grade 1 and grade 4 primary students in Beijing.
Methods: School-based, cross-sectional study. The children underwent a comprehensive eye examination including visual acuity (VA), non-cycloplegic refractometry and ocular biometry by optical low-coherence reflectometry. Parents and children had a detailed interview including questions on time spent indoors and outdoors, social-economic factors, et al.
Results: The prevalence of uncorrected, presenting, and best-corrected visual impairment (visual acuity≤20/40 inthe better eye) in rural was 4.3%, 4.2%, 0.6%, respectively., Correspondingly, the prevalence in urban children was 15.1%, 8.7%, 0%, respectively. Myopia alone or in combination with astigmatism resulted in the vast majority of visual impairment in rural and urban places. Spectacle use was reported by 54 (8.1%) children. 41 (75.9%) had myopia alone or in combination with astigmatism, 9 (16.7) had hyperopia alone or in combination with astigmatism, and 3 (5.6%) had astigmatism in at least 1 eye. Only one child did not have a significant refractive error in either eye. Use of spectacle was associated with older age (P<0.001), urban region of habitation (P<0.001) and maternal myopia (P=0.03).
Conclusions: Visual impairment in school-age children in urban and ruralBeijingregions is overwhelmingly caused by myopia, alone or combined with astigmatism. Compliance with spectacle wear may be very low. The results highlight the importance of improving glasses-wearing compliance, receiving eye care and initiating public education programs regarding the importance of dilation, early identification and correction of refractive error.