Abstract
WHAT IS ALREADY KNOWN ABOUT THIS TOPIC? Myopia prevalence among Chinese students remains persistently high, with axial length and the axial length-to-corneal radius ratio demonstrating significant associations with refractive status in children and adolescents. WHAT IS ADDED BY THIS REPORT? This investigation employed cycloplegic optometry to assess refractive errors across children and adolescents in 10 provincial-level administrative divisions, utilizing axial length (AL) and axial length-to-corneal radius ratio (AL/CR) as predictive indicators of refractive status. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE? The AL/CR ratio demonstrates superior predictive accuracy for myopia compared to AL alone and can effectively identify at-risk children during early developmental stages. Incorporating routine monitoring of AL and AL/CR into school health programs can enhance early detection capabilities and support targeted myopia management strategies.