Abstract:Objective: To analyze the prevalence, severity, types, and correction of astigmatism in children, aiming to provide scientific evidences for the prevention and treatment of refractive errors. Methods: This cross-sectional study included 29,153 children aged 6-12 years from Xi'an and Lantian County, Shaanxi Province. Visual acuity and non-cycloplegic refraction were measured. Astigmatism was defined as an absolute cylindrical power (DC) of ≥ 0.5D in the right eye. Differences in astigmatism severity, type distribution, and refractive correction were analyzed across age, gender, and region. Results: The prevalence of astigmatism increased with age, peaking at 11 years (62.88%). Boys (57.10%) had a higher prevalence than girls (54.86%), and in the municipal areas (58.29%) had a higher prevalence than county areas (51.75%). Mild astigmatism was the most common (63.82%), with both mild and moderate astigmatism increasing with age. The highest prevalence of high astigmatism was observed in 11-year-olds (9.68%). Compound myopic astigmatism (59.28%) and mixed astigmatism (25.16%) were the most frequent types. With increasing age, compound myopic astigmatism increased, while simple myopic, simple hyperopic, and compound hyperopic astigmatism decreased. Mixed astigmatism increased from ages 6 to 7, but declined from ages 7 to 12. For astigmatic axis types, with-the-rule astigmatism was the most prevalent (81.06%) and increased with age, peaking at 11 years (85.74%). Against-the-rule astigmatism showed a declining trend, while oblique astigmatism remained relatively stable. Distribution differences in astigmatism types and axes by gender and region were observed. Significant differences in astigmatism severity, types, and axis types across different ages, genders, and regions were observed (all P < 0.05). The overall refractive correction rate for children with astigmatism was only 40.18%. Conclusion: The overall prevalence of astigmatism among children aged 6-12 years in Shaanxi Province was 56.02%, with higher prevalence observed in boys and in municipal areas. Age, gender, and region significantly influenced the prevalence of astigmatism. Notably, less than half of the children with astigmatism received refractive correction, highlighting the need for increased attention from parents and relevant authorities.
