Abstract
PURPOSE: To investigate the prevalence of myopia among primary school students in Guangzhou and examine variations by district, grade level, gender, and parental engagement. METHODS: A total of 173,627 students from Grades 1-6 across 151 schools underwent vision screening between January and June 2024 in three districts of Guangzhou-Yuexiu (central urban core), Panyu (southern urban-rural fringe), and Huadu (northern rapidly urbanizing area). Uncorrected visual acuity and non-cycloplegic autorefraction were measured. Myopia was defined as uncorrected visual acuity < 5.0 and spherical equivalent refraction ≤ - 0.50 D. RESULTS: The overall prevalence of myopia was 36.97%. Significant regional differences were observed: 37.67% in Yuexiu, 32.56% in Panyu, and 38.92% in Huadu (p < 0.001). Female students consistently showed higher prevalence than males in all districts (p < 0.001). A clear trend of escalating myopia prevalence with advancing grade level, especially around the transition from lower to upper primary grades. Parental query rates were highest in Panyu (62.13%), followed by Yuexiu (53.34%) and Huadu (47.06%) (p < 0.05). CONCLUSION: District-level disparities in myopia prevalence were identified, underscoring the importance of region-specific considerations in future prevention strategies.