目的：分析西安市初中生视力不良现状及矫正情况，为近视防控工作提供依据。

方法：采用分层整群抽样方法，于2025年3月至2025年5月，纳入陕西省西安市的东方中学、西安理工大学附属中学及西安交通大学附属中学兴庆校区的初一年级1 726名、初二年级1 206名和初三年级1 042名，共计3 974名学生。使用5 m标准对数视力表采用单眼遮盖法检查视力，记录最小可辨视标的行视力值。采用台式电脑验光仪在非睫状肌麻痹状态下检测等效球镜度数(SE)进行屈光筛查。

结果：本研究纳入3 974名学生中有32名因故未参与检查，最终纳入分析的人数为3 942名。视力不良检出人数为3 067名(77.80%)。其中男生近视1 746名(81.47%)； 女生近视1 575名(87.55%)(P<0.01)。不同年级分层分析显示，初一年级近视1 386名(81.72%)，初二年级近视1 017名(84.47%)，初三年级近视918名(88.10%)，近视率随年级升高呈显著上升趋势(χ²=19.8484，P<0.01)。纳入的3 321名近视学生中，2 287名采取矫正措施，足矫为1 599名(48.15%)，欠矫688名(20.71%)，未矫1 034名(31.14%)。男生的未矫率显著高于女生(32.70% vs 29.40%， χ²=4.2222，P<0.05)。

结论：西安市初中生视力不良问题较为严重，配镜率和足矫率均偏低。需社会、学校和家庭共同参与，采取有效措施，遏制中学生近视的发生与发展。

METHODS: A stratified cluster sampling design was adopted. From March to May 2025, students in grades 7-9 were recruited from three schools in Xi'an, Shaanxi Province, China: Dongfang Middle School, the Middle School Attached to Xi'an University of Technology, and the Xingqing Campus of the High School Affiliated to Xi'an Jiaotong University. In total, 3 974 students were invited, including 1 726 in grade 7, 1 206 in grade 8, and 1 042 in grade 9. The visual acuity was measured monocularly using a 5 m standard logarithmic visual acuity chart, with the fellow eye occluded; the line corresponding to the smallest optotype that could be correctly identified was recorded as the visual acuity value. Non-cycloplegic autorefraction was performed with a desktop autorefractor to obtain spherical equivalent(SE)values for refractive error screening.

RESULTS: This study initially included 3 974 students, of whom 32 did not participate in the vision test, resulting in 3 942 students being included in the final analysis. Among them, 3 067(77.80%)were identified with poor vision. The prevalence of myopia was 81.47%(1 746)in males and 87.55%(1 575)in females(P<0.01). A stratified analysis by grade showed myopia rates of 81.72%(1 386)in junior grade one, 84.47%(1 017)in junior grade two, and 88.10%(918)in junior grade three, demonstrating a significant upward trend with increasing grade level(χ²=19.8484, P<0.01). Among the 3 321 myopic students, 2 287 adopted corrective measures. The rates of full correction, under-correction, and non-correction among all myopic students were 48.15%(1 599), 20.71%(688), and 31.14%(1 034), respectively. The rate of non-correction was significantly higher in male students than in females(32.70% vs 29.40%, χ²=4.2222, P<0.05).

CONCLUSION: The findings indicate a high prevalence of visual impairment among junior high school students in Xi'an, coupled with suboptimal spectacle-wearing and full-correction rates. There is an urgent need for collaborative efforts across society, schools, and families to implement effective interventions to slow the onset and progression of myopia in this population.