摘要目的:探究新疆南部某地中小学生中重度视觉损伤的患病率及影响因素，为当地的视力防控工作提供依据。方法:本研究为横断面调查研究。在2020年10月对新疆南部某地学校小学初中的全体学生2 604名进行集中眼科检查，其中男生1 330名、女生1 274名，年龄（11.6±2.9）岁，收集学生年级排名。用卡方检验比较不同性别的中重度视觉损伤患病率差异。H检验比较年龄、性别和成绩水平在中重度视觉损伤组和视力正常组之间的差异。logistic回归分析年龄、性别、成绩与低视力患病率的关系。结果:新疆南部某地中小学共2 604名学生参与调查，其中患有中重度视觉损伤人数77名，患病率为2.96%；造成中重度视觉损伤的原因是未矫正的屈光不正［100.00%（77/77）］。中重度视觉损伤患者中男生35名、女生42名，差异无统计学意义（ P=0.317）。视觉损伤组与视力正常组年龄［（13.0±2.0）岁比（11.7±2.8）岁］比较差异有统计学意义（ P<0.001），视觉损伤组成绩级排百分位比视力正常组靠前［（32.0±29.6）%比（65.6±21.8）%］（ P<0.001）。logistic回归分析表明，年龄和中上成绩是中重度视力不良的危险因素（ OR=1.195， P<0.001； OR=34.711， P<0.001），与性别无关（ P=0.066）。 结论:新疆南部某地中小学生中重度视觉损伤患病率较低，均为未矫正的屈光不正，危险因素包括年龄和较好的成绩。加强屈光不正的早期筛查，合理安排课业时间以及增加户外活动，可能有助于预防中重度视力损伤的发生发展。

abstractsObjective:To investigate the prevalence and risk factors of moderate to severe vision impairment among students in a primary and secondary school of southern Xinjiang, and to provide real-world evidences for low vision prevention.Methods:A cross-sectional study was conducted in October 2020, when a total of 2 604 students from a primary and secondary school in southern Xinjiang were given a centralized ophthalmic examination. Among them, there were 1 330 boys and 1 274 girls, aged (11.6±2.9) years. Chi-square test was used to compare differences in the prevalence of moderate to severe vision impairment by gender. H test was used to compare differences in the age, gender, and achievement levels between the moderate to severe vision impairment group and the normal vision group. Logistic regression analysis was used to explore the relationships between age, gender, and academic performance and the prevalence of severe visual impairment.Results:A total of 2 604 students in southern Xinjiang participated in the survey, of whom 77 cases had moderate to severe visual impairment, with a prevalence of 2.96%. The main cause of moderate to severe visual impairment was uncorrected ametropia [100.00% (77/77)]. There was no statistically significant difference in the prevalence of moderate to severe visual impairment between boys and girls (35/1 330 vs. 42/1 274) ( P=0.317). Inter-group differences showed that the age of the visual impairment group was significantly higher than that of the normal vision group [(13.0±2.0) years old vs. (11.7±2.8) years old] ( P<0.001), and the ranking of the visual impairment group was higher than that of the normal vision group [(32.0±29.6)% vs. (65.6±21.8)%] ( P<0.001). Logistic regression analysis showed that age and above-average academic performance were risk factors for moderate to severe visual impairment ( OR=1.195, P<0.001; OR=34.711, P<0.001), whereas gender was not related ( P=0.066). Conclusions:The prevalence of moderate to severe vision impairment among students in a primary and middle school of southern Xinjiang is low. The main cause of moderate to severe visual impairment is uncorrected ametropia. Risk factors include age and above-average academic performance. Strengthening early screening for ametropia, rationalizing study time, and increasing outdoor activities may help to prevent and control moderate to severe vision impairment.