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Visual impairment in rural and migrant Chinese school-going children: prevalence, severity, correction and associations
  1. Yue Ma1,
  2. Xinwu Zhang2,
  3. Fei He3,
  4. Xiaochen Ma4,
  5. Hongmei Yi5,
  6. Nathan Rose1,
  7. Alexis Medina1,
  8. Scott Rozelle1,
  9. Nathan Congdon6,7
  1. 1 Rural Education Action Program, Stanford University Freeman Spogli Institute for International Studies, Stanford, California, USA
  2. 2 School of Public Administration, Northwest University, Xi’an, China
  3. 3 Food and Resources Economics Department, University of Florida, Gainesville, Florida, USA
  4. 4 China Center for Health Development Studies, Peking University, Beijing, China
  5. 5 Center for Chinese Agricultural Policy, Peking University, Beijing, China
  6. 6 Preventive Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
  7. 7 Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
  1. Correspondence to Xinwu Zhang, School of Public Administration, Northwest University, 1 Xuefu Road, Chang’an District, Xi’an 710127, PR China; zhangxinwuceee{at}


Purpose To describe changes in the prevalence of visual impairment and glasses ownership with age and as associated with income and population density for visual impairment among rural and urban migrant Chinese students.

Design Meta-analysis of 12 cross-sectional, school-based studies conducted between 2012 and 2017.

Setting Rural and urban migrant schools in seven Chinese provinces.

Participants A total of 83 273 rural and urban migrant Chinese students aged 6–17 years.

Results Prevalence of visual impairment (uncorrected visual acuity ≤6/12 in either eye) rose from 19.0% at age 6 to 66.9% at 17, with the overall age-adjusted prevalence higher for girls (35.8%) than for boys (30.1%, p<0.001). The rate of glasses ownership among students who needed them increased from 13.0% at age 6 to 63.9% (p<0.001) at 17 and was significantly higher for girls (37.0%) than boys (34.7%, p<0.001). The unmet need for glasses as a proportion of the student population peaked in junior high school (31.8%). A 1% increase in per capita gross domestic product was associated with a 4.45% rise in uncorrected visual acuity (R2=0.057, p=0.020). Population density was significantly associated with glasses ownership among children (R2=0.359, p=0.012). A 1% population density increase was associated with an increase in the glasses ownership rate of 6.83%.

Conclusion Efforts are needed to improve vision screening coverage in China’s schools, particularly junior high schools, as this is when many rural children leave school and glasses coverage is lowest.

  • Vision
  • Public health

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  • Contributors YM and NC: conceptualisation; YM: data curation; YM and XZ: formal analysis; YM and FH: investigation; XM and HY: methodology; YM: project administration; SR: supervision.

  • Funding The authors are grateful for support from the 111 Project (Grant No. B16031). We are also grateful for financial and technical support from OneSight, Luxottica-China, Essilor, Caterpillar, BHVI and CLSA, which do not have award/grant numbers.

  • Competing interests NC is the Director of Research for Orbis International, a non-governmental organization that delivers children’s refraction service among other services in China and other countries.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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