目的：对兰州市中小学生的屈光状态进行调查分析，了解兰州市中小学生筛查性屈光不正的流行病学特征。方法：采用横断面研究方法，用随机分层抽样法抽取2021年4至12月在甘肃省兰州市47所学校的中小学生作为调查对象。以学校为单位，采用国际标准视力表检查视力，采用非睫状肌麻痹的电脑自动验光仪进行屈光检查。裸眼视力<0.8为视力低下，具体分为：近视为等效球镜度≥–0.75 DS；远视为等效球镜度≥+2.00 DS；散光为柱镜度≥1.00 DC；屈光参差为双眼屈光度数差值(等效球镜度)≥1.00 DS。比较不同年级不同屈光状态人数所占的百分比。结果：共纳入40 302人，其中男21 328人，女18 974人；汉族37 938人，少数民族2364人。小学、初中、高中各26 122、9346和4834人。视力低下的总检出率为59.1%(23 832/40 302)，小学、初中和高中年级视力低下的检出率分别为48.8%(12 748/26 122)，76.9%(7 189/9 346)和87.9%(4 250/4 834)。近视的总检出率为63.3%(25 521/40 302)，其中，小学、初中和高中筛查性近视的检出率分别为51.4%(13 438/26 122)，84.4%(7 888/9 346)和86.8%(4 195/4 834)。筛查性视力低下、远视、近视、散光及屈光参差的检出率在低中高年级间比较差异均有统计学意义(均P<0.001)。结论：兰州市中小学生视力低下和近视人群的检出率高于国家平均水平，且随着年级的增加检出率逐渐升高。

Objective: To investigate and analyze the refractive status of primary and secondary school students in Lanzhou City, and to understand the epidemiological characteristics of screening refractive errors among primary and secondary school students in Lanzhou City. Methods: Using the cross-sectional research method, primary and secondary school students from 47 schools in Lanzhou City, Gansu Province from April to December 2021 were selected as survey subjects by random stratified sampling method. Taking school as a unit, international standard visual acuity chart was used to check the eyesight and non-cycloplegia computerized autorefractor was used for refractive examination. Visual acuity ≥5.0 is considered normal; whereas visual acuity <4.8 is considered as poor vision. Poor vision is further divided into: short-sightedness with myopic spherical equivalent ≥0.75 DS; long-sightedness with telephoto spherical equivalent ≥+2.00 DS; astigmatism with cylinder mirror equivalent ≥1.00 DC; anisometropia with the difference of diopters between the two eyes (spherical equivalent) ≥1.00 DS. The percentage of the survey subjects with different refractive status in different grades were compared. Results: A total of 40 302 subjects were enrolled, including 21 328 males and 18 974 females. There were 37 938 Han and 2 364 ethnic minorities; 26 122 elementary, 9 346 middle and 4 834 high schools. The total detection rate of low visual acuity was 59.1% (23 832/40 302), and 48.8% (12 748/26 122) in primary school, junior middle school and senior high school, 76.9% (7 189/9 346) and 87.9% (4 250/4 834), respectively. The total detection rate of myopia was 63.3% (25 521/40 302), among which, the detection rate of screening myopia in primary school, middle school and high school was 51.4% (13 438/26 122), 84.4% (7 888/9 346) and 86.8% (4 195/4 834), respectively. The detection rates of screening low visual acuity, hyperopia, myopia, astigmatism and anisometropia were statistically significant in low, middle and high grades (all P<0.001). Conclusion: The detection rate of low vision and myopia among primary and secondary school students in Lanzhou is higher than the national average, and the detection rate increases gradually with the increase of grades.

目的：了解汕头地区城乡中小学生隐性斜视的患病现况，为防治斜视提供依据。方法：横断面研究，随机整群抽样调查。在汕头地区调查9所城乡中小学校，共7 537人。眼位检查采用33 cm角膜映光法，视远视近遮盖去遮盖与交替遮盖法；记录检查结果并按年级、城乡、不同类型眼位等特征进行归类，统计学方法分析总结。结果：完成调查人数共7 464人，其中男女分别为3 928和 3 536人，平均年龄11岁；本调查人群内、外隐斜视患病率分别为3.08%和60.65%，小学生内隐斜视率高于初中、高中学生内隐斜视率(P<0.001)；高中学生外隐斜视率高于小学、初中学生外隐斜视率(P<0.001)，特别是以高三年级学生外斜视率最高；农村学生的内、外隐斜视率均高于城市学生(P<0.05)；logistic回归模型显示隐斜视率与年龄、性别无明显相关性。结论：首次报道了国内学生 中隐性斜视的分布特点，即内隐性斜视以小学生多，外隐斜视以高中生多，农村学生的隐斜率高于城市学生，可能与中国学生的屈光发育状态有关。

Objective: To investigate the prevalence of heterophoria among urban and rural students in Shantou City of Guangdong Province, China. Methods: Cluster sampling was used in randomly selecting 7 537 students from 9 schools in Shantou City. Ocular alignment was assessed by using the Hirschberg light reflex and cover test. Cover testing was performed by using fixation targets at both distance (6 m) and near (30 cm). Statistical analyses were performed using SPSS statistical software to investigate the association of age, grades and schools and different types of strabismus. Results: A total of 7 464 students were examined  (participation rate was 99.03%), including 3 928 boys and 3 536 girls, mean age 11 years. The prevalence of esophoria and exophoria were3.08% and 60.65%. Esophoria prevalence of primary school students have the signiffcant difference (P<0.001) contrast with middle school students and high school students. And prevalence of exophoria was highest in high school students and significantly higher than middle and primary school students respectively (P<0.001). Heterophoria was more prevalent in rural school students than urban school students(P<0.05). Multivariate logistic regression model indicated that the prevalence of heterophoria had no significant correlation with grades and ages. Conclusion: This survey first reported the prevalence of heterophoria in China. The prevalence of esophoria appears to be higher in primary students and exophoria was highest in high school students; Prevalence of Heterophoria in the population of this survey generally showed higher in rural school students than urban areas. These may be associated with refraction in Chinese students. 

目的：通过三棱镜融合储备力试验检查了解正常青少年的双眼水平融像性聚散范围。方法：横断面研究，随机分层整群抽样调查。在汕头地区调查9所城乡中小学校，共7 537人。从体检学生中抽取双眼正常学生4 012名，用排状三棱镜检查双眼近距水平聚散力，在融像破裂点记录三棱镜度数。按集合与散开、年龄、性别等因素对结果作分层统计分析。结果：总体检人数7 464人，其中双眼祼眼视力≥0.8为4 012人，占体检人数的53.75%；研究对象的双眼散开运动范围平均为15.87△±10.74△，双眼集合运动范围平均为26.41△±12.04△；4~8岁组及9~11岁组的双眼集合与散开运动范围均高于12~20岁组，差异有统计学意义(P<0.05)；女性的双眼集合能力高于男性。结论：在本调查人群中，双眼集合运动的储备力高于散开运动；年龄越小，双眼异向运动的储备力越强。

Objective: To investigate the fusional range by using prism bar among students in Shantou City of Guangdong Province, China. Methods: This was a cross-sectional study that included 4 012 normal eye subjects among randomly selected 7 537 students aged 6 to 19 years from 9 schools in Shantou City. Horizontal fusional range measured with prism bar. Statistical analyses were performed using SPSS statistical software to investigate the association of age, gender, vergence and divergence. Results: A total of 7 464 students were examined, including 3 928 boys and 3 536 girls, mean age 11 years. The number of students with binocular vision ≥0.8 was 4 012, accounting for 53.75% of the number of fusional examination; the mean vergence range was 15.87△±10.74△, and the mean divergence range was 26.41△±12.04△. The vergence and divergence range group of 4 to 8 years and 9 to  11 years students was higher than the group of 12 to 20 years, the difference was statistically significant (P<0.05). The vergence range of female students was higher than that of male students. Conclusion: In this study, the vergence range is higher than divergence. With an increase in ages, the range of vergence and divergence decreases.