JMIR Publications

ABSTRACT

Background:

Poor vision has been recognized a challenging public health problem among children and adolescents over the world and in China.

Objective:

The study aims to investigate the progression of poor vision among children and adolescents in Wuhan, China based on a prospective cohort, and provide scientific evidence for the development and implementation of effective poor vision prevention and control programs.

Methods:

Study data were derived from a four-year prospective cohort (2016-2019) of primary and middle school students (N=108,585) in Wuhan, China. The vision condition was measured using the Standard for Logarithmic Visual Acuity Charts. Group-based trajectory model (GBTM) was used to identify the trajectories of poor vision overall and by gender and region.

Results:

The mean age of the study subjects was 11.13 (3.33) years, 53.91% among them were male and majority (95.42%) came from urban area. The prevalence of poor vision was 58.51% in 2016, and 58.95% in 2017, 53.83% in 2018, and 54.79% in 2019. GBTM identified three groups, including normal vision group (NVG) (27.4%), vision decline group (VDG) (17.8%) and moderate poor vision group (MPV) (54.8%). It was observed that the proportion of the MPV was higher in girls (57.8%) compared to boys (50.5%), and the VDG showed a greater magnitude of change in girls compared to boys. Furthermore, the proportion of the MPV was higher in urban areas (55.3%) compared to rural areas (47.5%), while the VDG was smaller in urban areas (17.2%) compared to rural areas (24%). Further analyses showed that with the increasing of age, the likelihood of categorizing into the NVG declined (β=-0.417, p<0.0001), while the likelihood of being the VDG (β=0.058, p<0.0001) increased. Compared with boys, girls were more likely to be categorized into the VDG (β=0.597, p<0.0001) and MPV (β=0.362, p<0.0001), while compared with urban students, students from rural areas were less likely to be categorized into VDG (β=-0.311, p<0.0001).

Conclusions:

The prevalence of poor vision among children and adolescents in Wuhan has remained high over the years, with a slight decrease in recent years. The study identified three groups of normal vision, vision decline, and moderate poor vision. Girls and those from urban areas had a higher proportion of moderate poor vision, while boys and those from rural areas had a higher proportion of vision decline. These findings provide valuable information for implementing poor vision prevention and control policies in the district.