Three-year surveillance of myopia trends and urban–rural disparities among schoolchildren in a Coastal City of Southern China

Wenting Hou, Tianfeng Lai, Qiuling Pan, Fangjiao Tang, D-P Chen, Zhijie Shen, Junhui Fu, 蘇介民, Linyan Zhang, Qi Chen, Xianxian Wei

Objective Myopia has become an increasingly important vision health concern among children and adolescents in China. However, longitudinal surveillance data from less-developed coastal regions remain limited. This study aimed to investigate temporal trends and demographic differences in myopia prevalence among school students in Qinzhou, Southern China, using three consecutive years of school-based screening data. Methods A repeated cross-sectional study was conducted from 2022 to 2024 in 40 primary and secondary schools in Qinzhou, China. A total of 90,072 screening records from students aged 6–18 years were included. Uncorrected visual acuity and non-cycloplegic autorefraction were assessed using standardized examination procedures. Myopia was defined according to spherical equivalent refraction. Differences in myopia prevalence by sex, educational stage, residential region, and age group were analyzed using chi-square tests and binary logistic regression models. Results Overall myopia prevalence increased from 43.17% in 2022 to 48.21% in 2023 and remained high in 2024 (47.51%). Female students consistently showed higher myopia prevalence than male students across all years (all p < 0.001). Myopia prevalence increased significantly with advancing educational stage and age, particularly after 12 years of age. Within matched educational stages, urban students demonstrated persistently high prevalence rates, whereas larger year-to-year fluctuations were observed among rural and township students. In addition, the proportions of moderate and high myopia increased with age. Although a slight decrease in prevalence was observed in 2024, the overall burden of myopia remained substantial. Conclusion Myopia prevalence among school-aged children and adolescents in Qinzhou remained high during the study period, with significant disparities across sex, age, educational stage, and residential region. These findings highlight the need for early preventive interventions and region-specific myopia control strategies, particularly for younger students and underserved populations.