Abstract: Objective To investigate the current situation of visual health of children and adolescents in the primary, junior, and high schools in Shanghai Songjiang District in 2020, and to analyze its influencing factors, so as to provide guidance for the timely intervention of children and adolescents with poor vision. Methods From September to December in 2020, 7 schools in Shanghai Songjiang District were randomly selected as vision monitoring sites to check naked distal vision and the dilated refractive status under non-cycloplegia, including 2 primary schools, 2 junior high schools, and 3 high schools. A stratified cluster random sampling method was used to select 2 036 students to conduct a questionnaire survey. Then the influencing factors of poor eyesight were analyzed. Results Among 2 036 students, there were 1 381(67.83%) students with poor eyesight and 1 111(54.57%) students with myopia. The rates of myopia in primary school junior high school, and high school students were 25.40%, 73.44% and 88.99%, respectively. With the higher of grade, the rate of myopia increased continuously and the linear trend was significant (Z=26.204, P<0.001). Students have many bad habits of using eyes, such as using eyes too close, using eyes for a long time, not positively taking rest and so on. Multivariate analysis showed that female (OR=1.354,95%CI:1.116 - 1.642), myopia of parents (OR=1.470, 95%CI:1.207 - 1.790), and longer time for doing homework (OR=2.903, 95%CI:2.080 - 4.050) were risk factors for poor vision, while outdoor exercise(OR=0.678, 95%CI:0.533 - 0.863) and rest after continuous eye use for 30~40 min(OR=0.686, 95%CI:0.511 - 0.920) were protective factors. Conclusions The rates of poor vision and myopia in children and adolescents in Shanghai Songjiang district are relatively high, which was closely related to the habits and duration of using eyes. It is necessary to increase children and adolescents'outdoor exercise time, to strengthen eye hygiene and health education, and to take regular vision examination and early interventions.

Key words: children and adolescents, poor eyesight, myopia, outdoor activities

摘要： 目的 调查2020年上海市松江区小学、初中、高中儿童青少年视力健康现状并探讨其影响因素,为儿童青少年视力不良及时干预提供指导意见。方法 于2020年9-12月,随机抽取上海市松江区7所学校为视力监测点(2所小学、2所初中、3所高中),检查裸眼远视力、非睫状肌麻痹下的散瞳屈光状态,并分层整群随机抽取2 036名学生进行问卷调查,分析视力不良的影响因素。结果 2 036名学生中,视力不良学生1 381名(67.83%),筛查出近视学生1 111名(54.57%),小学、初中、高中近视率分别为25.40%、73.44%、88.99%,随着年级增加,近视率不断上升,线性趋势显著(Z=26.204,P＜0.001),学生存在诸多不良用眼习惯,如用眼距离过近、长时间用眼、不注意主动休息等。多因素分析结果显示,女性(OR=1.354,95%CI:1.116~1.642)、父母近视(OR=1.470,95%CI:1.207~1.790)、做作业时长较长(OR=2.903,95%CI:2.080~4.050)是视力不良的危险因素,户外运动(OR=0.678,95%CI:0.533~0.863)、持续用眼30~40 min后休息(OR=0.686,95%CI:0.511~0.920)是视力不良的保护因素。结论 上海市松江区儿童青少年视力不良率及近视率较高,与用眼习惯和时长关系密切,应增加学生户外运动时间、加强眼卫生健康教育,定期视力检查并及早干预。

关键词: 儿童青少年, 视力不良, 近视, 户外运动