Association of School Education With Eyesight Among Children and Adolescents

A cross-sectional study conducted in China involving approximately 813,000 students aimed to investigate the relationship between years of school education and myopia (nearsightedness) rates. The study found that every additional year of school education was associated with a decrease in mean spherical equivalent refractive error (MSE) and a decrease in uncorrected visual acuity (UVA), both of which are indicators of myopia. The most significant shifts in MSE occurred in grades 3 and 7. These findings suggest that receiving more years of education, rather than age alone, may be a risk factor for myopia progression in youth. Myopia is a growing global issue, particularly in regions with intense educational systems like East Asia and Southeast Asia. This study sheds light on the impact of education, examination pressure, and digital screen time on myopia rates. Factors such as preparing for examinations, educational pressure, and competition were identified as potential mediators in the association between school education and myopia. The study highlights the importance of early intervention to control myopia progression, particularly for students in primary school grades, such as grade 3.

Publication date

April 29, 2022


JAMA Network Open

Sponsor Institution

Key Program of the National Social Science Foundation of China, Zhejiang Provincial Natural Science Foundation of China, Key Research and Development Program of Zhejiang Province, Australian Commonwealth Government, Key Research and Development Program of Zhejiang Province


Chunfeng Zhang; Ling Li; Catherine Jan; Xiang Li
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