Development and Application of a Smartphone-Based App for Screening Myopia and Astigmatism in Elementary School Students

Abstract

This study aimed to develop a smartphone-based application for visual acuity and astigmatism screening among elementary school students and to investigate the prevalence and progression patterns of these refractive problems across different grades and genders. The application was developed using the Uni-App framework, integrating standardized logarithmic visual acuity charts and astigmatism screening diagrams. A total of 904 students from grades 1 to 6 were recruited. Self-administered tests were performed under standardized conditions. Data on visual acuity and astigmatism were collected over six months and analyzed by grade and gender. The overall prevalence of myopia was 56.1% (507/904). Myopia prevalence increased markedly with grade, from 37.4% in Grade 1 to 81.1% in Grade 6. A significant gender disparity was observed in Grade 6, where 91.9% of girls and 70.8% of boys had myopia. Astigmatism prevalence also increased with grade, from 29.8% to 57.5%, largely driven by its comorbidity with myopia. In summary, the Eye-Health application proved to be an effective tool for large-scale, school-based vision screening. The findings highlight a critically high and grade-dependent prevalence of refractive errors among Chinese elementary school students, with girls being particularly vulnerable in higher grades. The findings of this study provide evidence-based references for families, schools, and health departments to formulate targeted prevention and control strategies, thereby facilitating early warning and tailored interventions.