Objective: To investigates the visual condition and myopia status in primary school students of grade 1 to 3 in Hubei province and to further analyze the influencing factors of myopia, so as to provide theoretical basis for prevention and control of myopia. Method: Cross-sectional study. A total of 18 532 primary school students from grade 1-3 in 26 primary schools from 17 prefecture-level cities in Hubei province were included in the study from March 2017 to July 2017, by using a random stratified cluster sampling method. In this study, 16 955 people were actually surveyed, with a response rate of 91.49%. All students' Visual acuity was measured, a further retinoscopy refraction test after application of Cyclopentolate Hydrochloride Eye Drops was conducted for those whose visual acuity was less than 5.0. The general situation and eye behavior of all students were investigated by questionnaires. Chi-square test was used to compare the prevalence of myopia between different grades, different regions and different genders, as well as the distribution of myopia correlation between different regions, and Logistic regression model was used to analyze the correlation between myopia and related factors. Results: The prevalence of myopia among primary school students of grade 1 to 3 in Hubei province is 24.15% with 12.67% in the first grade, 24.91% in the second grade, 34.95% in the third grade, and the difference was statistically significant (χ(2)=862.28, P<0.05). According to the study, mild myopia is the most prevailing condition among myopia students, with the prevalence rate of mild myopia, moderate myopia and severe myopia being 19.21%,4.29%, and 0.64% respectively, and the difference is statistically significant (χ(2)=155.62, P<0.05). In addition, the prevalence of myopia is different in each region, which was highest in provincial capitals, followed by non-provincial cities, and the lowest in rural areas, with statistically significant difference (χ(2)=539.57, P<0.05). Myopia is generally related to multiple factors, such as the grade, parents' myopia, outdoor activities, continuous closing reading, exposure to electronic products, and extracurricular reading time are related to myopia (P<0.05). Conclusions: Children's myopia is a public health problem that should not be ignored. The prevalence of myopia among 1-3 grade pupils is 24.15% with an increasing tendency with grade. The occurrence of myopia is related to heredity and eye behavior. (Chin J Ophthalmol, 2018, 54:756-761).
目的： 了解湖北省一至三年级小学生视力情况及近视眼现状，分析近视眼的影响因素，为近视眼防控提供理论依据。 方法： 横断面研究。采用随机分层整群抽样方法，于2017年3至7月抽取湖北省17个地市（州）26所小学一至三年级小学生共18 532人，有效调查16 955人，应答率91.49%。对纳入对象行视力检查，视力<5.0则进一步使用赛飞杰睫状肌痳痹后检影验光；问卷调查学生的一般情况及用眼行为。采用卡方检验比较年级、地域及性别间近视眼患病率的差异及不同地域间近视眼相关情况的分布，二项Logistic回归分析近视眼的影响因素。 结果： 湖北省一至三年级小学生近视眼患病率为24.15%（4 094/16 955）；近视眼患病率随年级增加而增高，一年级为12.67%（737/5 816），二年级为24.91%（1 330/5 340），三年级为34.95%（2 027/5 799），差异具有统计学意义（χ(2)=862.28，P<0.05）。近视眼学生的屈光状态以轻度近视眼为主，轻度、中度、高度近视眼患病率分别为19.21%（3 257/16 955）、4.29%（728/16 955）、0.64%（109/16 955），差异具有统计学意义（χ(2)=155.62，P<0.05）。省会城市小学生近视眼患病率最高[26.61%（1 490/5 600）]，其次为非省会城市[22.19%（1 614/7 272）]，农村地区最低[7.96%（325/4 083）]，差异有统计学意义（χ(2)=539.57，P<0.05）。近视眼与多因素相关，年级、父母近视眼、户外活动时间、持续近距离用眼时间、接触电子产品及参加课外学习均与近视眼的发生具有相关性（P<0.05）。 结论： 儿童近视眼为不容忽视的公共健康问题，湖北省一至三年级小学生近视眼患病率为24.15%，随年级增加近视眼患病率增高；近视眼的发生与遗传和用眼行为相关。（中华眼科杂志，2018，54：756-761）.
Keywords: Cross-sectional studies; Myopia; Prevalence; Students.