Abstract: Objective To analyze the influencing factors of myopia among primary and secondary school students in Urumqi, to investigate the roles of genetic and environmental factors in the development of myopia, and to provide a scientific basis for regional myopia prevention and control. Methods This cross-sectional study included 10 891 primary and secondary school students. Refractive status was measured using an automated refractometer, and demographic and behavioral data were collected through questionnaires. Results Among the 10, 891 students, the overall prevalence of myopia was 74.6%, with mild myopia accounting for 37.3% and high myopia for 1.8%. Ordinal logistic regression analysis revealed that risk factors for myopia included older age (for each additional year, the risk increased by 21.4%, OR=1.214), female sex (risk increased by 38.0%, OR=1.380), parental myopia (if one parent was myopia, risk increased by 71.3%, OR=1.713; if both parents were myopia, risk increased by 108.5%, OR=2.085), reading or writing at a distance of <30 cm (occasional: risk increased by 52.2%, OR=1.522; frequent: risk increased by 134.2%, OR=2.342), poor reading posture (e.g., lying down while reading, risk increased by 20.1%, OR=1.201), and prolonged continuous reading (1-2 hours: risk increased by 15.7%, OR=1.157; >2 hours: risk increased by 27.9%, OR=1.279). Protective factors included being to other ethnic groups (risk decreased by 48.5%, OR=0.515), taking eye breaks after 1 hour of reading (risk decreased by 28.9%, OR=0.711), and engaging in more than 2 hours of outdoor activities per day (risk decreased by 15.1%, OR=0.849) (all P<0.05). Conclusions The prevalence of myopia among primary and secondary school students in Urumqi is associated with sex, age, ethnicity, behavioral habits, and genetic factors. Improving reading habits, increasing outdoor activities, and standardizing eye-use behavior may help slow the onset and progression of myopia.

Key words: Primary and secondary school students, Influencing factors, Vision, Myopia, Myopia Prevention and Control, Myopia Risk