Monday, March 30, 2026

Meta-analysis: Myopia prevalence 30.1% in Chinese children/adolescents, peaks at 81.0% in high school

Key Takeaway
Consider marked age, sex, and regional disparities in myopia prevalence when planning public health interventions for Chinese youth.

This systematic review and meta-analysis aimed to assess the prevalence of myopia, diagnosed by cycloplegic refraction (spherical equivalent ≤-0.50 D), among Chinese children and adolescents. The analysis included population- or school-based studies published between January 2020 and March 2025 that used cycloplegic refraction, identified via searches of PubMed, Web of Science, Science Direct, CNKI, and Wanfang. The overall pooled prevalence of myopia across 34 studies with 139,765 participants was 30.1%. Subgroup analyses revealed a higher prevalence in females (28.6%) compared to males (26.0%). Prevalence increased markedly with educational stage: 4.2% in kindergarten, 28.4% in primary school, 64.1% in junior high, and 81.0% in high school. Analysis by time period showed the prevalence peaked in 2016 at 57.5%. Geographically, the highest provincial prevalence was observed in Taiwan (66.5%), while the lowest was in Henan (6.6%). At the regional level, Eastern China had the highest prevalence (40.3%), prevalence was close to the national average in Northwestern China (31.2%), and the lowest prevalence was in Central China (6.6%). Publication bias was assessed using Egger's and Begg's tests, though specific results of these tests were not provided in the abstract. The study was registered with PROSPERO (CRD420251236626).

View Original Abstract ↓
BACKGROUND: There is currently a lack of nationally representative assessments of myopia based on gold-standard cycloplegic refraction among Chinese children and adolescents. Therefore, we aimed to systematically review and meta-analyse the prevalence of myopia, diagnosed by cycloplegic refraction (spherical equivalent ≤-0.50 D), among Chinese children and adolescents, and examine its distribution across sexes, age groups, time periods, and geographic regions. METHODS: We searched PubMed, Web of Science, Science Direct, CNKI, and Wanfang for population- or school-based studies published between January 2020 and March 2025 that used cycloplegic refraction. We calculated the pooled prevalence and 95% confidence intervals using a meta-analysis, with subgroup analyses by sex, educational stage, time periods, and regions. We assessed publication bias using Egger's and Begg's tests. RESULTS: The overall myopia prevalence among 34 studies with 139 765 participants was 30.1%. Prevalence was higher in females (28.6%) than males (26.0%) and increased markedly with education stage from 4.2% in kindergarten, 28.4% in primary school, 64.1% in junior high, and 81.0% in high school. Temporally, prevalence peaked in 2016 (57.5%). Geographically, the highest provincial prevalence was observed in Taiwan (66.5%), while the lowest was identified in Henan (6.6%). At the regional level, Eastern China had the highest prevalence (40.3%), close to the national average in Northwestern China (31.2%), and the lowest in Central China (6.6%). CONCLUSIONS: The pooled prevalence of myopia among Chinese children and adolescents was 30.1%, with a pronounced increase by educational stage. A slightly higher prevalence was observed in females. Geographically, Eastern China had the highest burden, while Central China had the lowest. These findings highlight marked age, sex, and regional disparities, providing evidence for targeted public health interventions. REGISTRATION: PROSPERO: CRD420251236626.