目的：评估分析新疆地区14个地州6~18岁学龄儿童青少年屈光参差的患病率、空间分布特征和影响因素，为制定区域性眼健康干预策略提供科学依据。方法：采用横断面研究设计，纳入新疆地区14个地州的小学、初中及高中学生共64 277名，收集其人口学特征、屈光状态及地域分布数据。通过等效球镜度（spherical equivalent，SE）评估屈光状态，近视为SE ≤ -0.50 D，屈光参差为眼间SE差异≥1.0 D，采用Moran's I分析屈光参差患病率的空间分布，采用单因素及多因素回归分析探讨屈光参差的危险因素。结果：屈光参差的总体患病率为17.9%（95% CI：17.6%～18.2%），女性屈光参差患病率（18.8%）高于男性（16.9%），汉族（23.9%）高于维吾尔族（11.7%）和其他民族（18.4%）（P<0.001）。屈光参差患病率呈空间聚集分布(Moran's I = 0.450，P = 0.043，Z = 2.026)，并且存在地域差异，昌吉最高（24.1%），克孜勒苏柯尔克孜自治州最低（7.9%），城市（19.0%）高于农村（15.6%），北疆（19.9%）高于南疆（13.5%）（P<0.001）。屈光参差的患病率与年龄呈正相关，6岁为9.8%，18岁达22.4%。多因素回归分析显示，女性、北疆地区、近视和较高年龄是屈光参差的独立危险因素（P<0.05）。结论：新疆地区学龄儿童青少年屈光参差患病率较高，在空间上呈聚集分布，且存在显著的人口学及地域差异，女性、北疆地区、近视和较高年龄是屈光参差的独立危险因素，建议加强对高危人群的视力筛查及早期干预。  

Objective: To evaluate and analyze the prevalence, spatial distribution characteristics, and influencing factors of anisometropia among school-aged children and adolescents aged 6-18 across 14 prefectures in Xinjiang, thereby providing a scientific foundation for formulation of regional eye health intervention strategies. Methods: A cross-sectional study design was employed, including 64,277 students from primary, middle, and high schools in 14 prefectures of Xinjiang. Data on demographic characteristics, refractive status, and geographical distribution were collected. Refractive status was assessed using spherical equivalent (SE). Myopia was defined as SE ≤ -0.50 D, and anisometropia was defined as an interocular SE difference ≥ 1.0 D. Moran's I analysis was used to evaluate the spatial distribution of anisometropia prevalence. Additionally, univariate and multivariate regression analyses were conducted to identify risk factors for anisometropia. Results: The overall prevalence of anisometropia was 17.9% (95% CI: 17.6%-18.2%). The prevalence was higher among females (18.8%) compared to males (16.9%), and higher among Han Chinese (23.9%) than among Uyghurs (11.7%) and other ethnic groups (18.4%) (P<0.001). The prevalence of anisometropia showed a spatially clustered distribution (Moran's I = 0.450, P= 0.043, Z-score = 2.026) , with notable regional variations. Changji had the highest prevalence (24.1%), while Kizilsu Kirghiz Autonomous Prefecture had the lowest (7.9%). Urban areas (19.0%) had a higher prevalence than rural areas (15.6%), and northern Xinjiang (19.9%) had a higher prevalence than southern Xinjiang (13.5%) (P<0.001). The prevalence of anisometropia was positively correlated with age, increasing from 9.8% at age 6 to 22.4% at age 18. Multivariate regression analysis showed that female gender, residing in northern Xinjiang, myopia, and older age were independent risk factors for anisometropia. Conclusions: The prevalence of anisometropia among school-aged children and adolescents in Xinjiang is relatively high, showing a spatially clustered distribution with significant demographic and regional disparities. Female gender, residing in northern Xinjiang, myopia, and older age are independent risk factors for anisometropia. It is recommended to enhance vision screening and implement early intervention for high-risk populations.