Abstract
Background: Refractive errors and visual impairment in southernmost China have not been reported previously. We aim to investigate and determine the age-specific prevalence of myopia, hyperopia, astigmatism, and visual impairment based on a large population cross-sectional study in Hainan area of southernmost tropical province in China. Methods: A population-based sample of 31,524 children aged 6-15 years from Hainan was assessed. Non-cycloplegic autorefraction and visual acuity (VA) analyses were performed on all participants and a subgroup of participants undergoing cycloplegia. Results: Of all participators, 22.986% presented uncorrected VA (UCVA) decreased worse than 0.3logMAR, 17.206% presented UCVA decreased worse than 0.5logMAR and 46.95% presented abnormal UCVA [worse than 0.1logMAR (≥6, <8 years old) and worse than 0logMAR(≥8years and older)] at least in one eye. The overall prevalence of myopia [spherical equivalent (SE) ≤−0.50 D] and high myopia (SE≤−6.00 D) were 45.97%, 0.96% respectively. Hyperopia [SE ≥+1.00 D (≥7 years old) and SE ≥+2.00 D (≥6, <7 years old)] and significant hyperopia (SE≥+3.00 D) were 4.21% and 0.62%, respectively. Astigmatism [cylinder≥1.00 D (≥7 years old) and ≥+1.75 D (≥6, <7 years old)] was found in 31.87%. Conclusions: Myopia was the most common refractive error in southernmost province in China (Hainan). Its prevalence increased with age, while hyperopia prevalence showed a decreasing trend. However, myopia, especially high myopia prevalence was much lower than in other urban regions across China, as residents of Hainan may benefit from more ultraviolet B (UVB) radiation during daylight exposure.