Vision screening of school-aged children in Wuqia County: a cross-sectional study in western China

Objective To investigate the prevalence of reduced visual acuity (VA) among school-aged children in Wuqia County, western China. Methods In this cross-sectional study, 9,094 primary and junior middle school students in Wuqia County underwent vision screening in November 2024. Uncorrected visual acuity (UCVA) was measured using a LogMAR tumbling E chart, with reduced VA was defined as UCVA < 20/30 in either eye. We also analyzed associations between reduced VA and factors such as gender, grade level, and residential area (urban vs. rural). Results The overall prevalence of reduced VA among school-aged children in Wuqia County was 21.52% (1,957/9,094). The prevalence of reduced VA was significantly higher in female children (26.62%, 1,151/4,324) than in males (16.90%, 806/4,770) ( P < 0.01). The occurrence of reduced VA increased significantly with higher grade levels ( P < 0.01), from 8.10% in grade 1–31.03% in grade 9. Furthermore, from grade 3 onwards, the prevalence of reduced VA was consistently higher in females compared to males ( P < 0.05). Additionally, the prevalence of reduced VA was significantly higher in urban primary schools (21.33%, 635/2,977) than in rural primary schools (15.32%, 564/3,682) ( P < 0.01). Multivariate analysis identified higher grade level, female gender, and urban school location as independent factors associated with an increased risk of reduced VA (all P < 0.001). Conclusion This study revealed a significant burden of reduced VA among school-aged children in Wuqia County. The findings provide valuable insights for developing targeted interventions and public health policies aimed at improving eye care services in the high-altitude regions of western China.