ArticleFrontiers in public health2026
Real-world evidence on childhood refractive errors in a developed coastal region of China: a multi-center analysis of 4.47 million school-based screening encounters in Southern Fujian.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Despite rapid economic development in coastal China, the alignment between socioeconomic growth and pediatric eye health remains poorly understood. School-based screening may provide an opportunity to bridge this knowledge gap, yet large-scale, real-world evidence from diverse urban-rural gradients is scarce. Methods: This cross-sectional study analyzed 4.47 million valid screening encounters from Xiamen, Quanzhou, and Zhangzhou (2021-2024). Visual acuity (VA) and spherical equivalent (SE) were assessed. Two-way ANOVA and multivariate logistic regression were employed to identify drivers of visual impairment and uncorrected refractive error, with screening year as a covariate. Generalized Estimating Equations (GEE) with student-level clustering were applied to account for repeated measures. Sensitivity analyses confirmed dataset robustness. Results: Age was the predominant driver of VA variance (η Conclusion: Economic prosperity does not automatically translate to optimal visual health. Significant "correction gaps" and intra-regional disparities necessitate a shift from uniform strategies to precision governance. Future interventions must prioritize the 5-7-year window, emphasize correction quality over mere screening volume, and tailor approaches to local socioeconomic contexts to transform economic capital into sustainable ocular health dividends effectively.
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