Abstract / Summary
Abstract Background This epidemiological survey investigates the prevalence of high myopia among children and adolescents aged 6–18 years in Hubei Province, analyzing its distribution and exploring factors that influence its onset and progression. Methods This school-based, prospective cross-sectional study was conducted from September 2021 to December 2023. Basic demographic information was collected, and participants underwent non-cycloplegic autorefraction examination. A two-stage sampling method was employed to conduct detailed surveys on visual habits and influencing factors among a subgroup of 31,695 students. Chi-square and Mann-Whitney U tests were used to analyze the prevalence and influencing factors of high myopia across different characteristics. XGBoost was utilized to rank the risk factors contributing to high myopia prevalence. Results The study included 1,126,311 participants, with 604,130 males (53.60%), and an average age of 11.44 ± 3.42 years, ranging from 6 to 18 years. A total of 28,543 valid questionnaires on visual habits were analyzed. The prevalence of high myopia among children and adolescents aged 6–18 years was 4.87%. The rate increased with educational grade, displaying a nonlinear upward curve, with the sharpest increase between the ninth and tenth grades (2.84%). Females exhibited higher rates of high myopia across all educational stages. Urban children and adolescents had a higher prevalence of high myopia compared to their rural counterparts (χ² = 3665.29, P < 0.001). XGBoost analysis reveals that the top five factors influencing high myopia prevalence are educational grade, parents with myopia, sleep duration, mother’s education, preterm birth. Conclusions The prevalence of high myopia increases with educational grade, with the sharpest rise occurring between the ninth and tenth grades. Females consistently showed higher rates. Urban areas had a slightly higher prevalence than rural areas. Developing differentiated intervention strategies for various populations might lead to more efficient prevention of high myopia and its complications.