Myopia is a refractive error, and in recent years, the prevalence of myopia among children and adolescents has remained high and has shown a tendency to be at a younger age, posing a great threat to the physical and mental health of children and adolescents. Currently, there are few systematic studies on myopia and risk factors in children and adolescents.

To explore the prevalence and influencing factors of myopia among children and adolescents in China using Meta-analysis.

A combination of Mesh subject terms and free terms was used to search for information on the prevalence of myopia in the databases of Web of Science, PubMed, Cochrane Library, China Knowledge Network (CNKI), Wanfang Data, VIP, and China Biomedical Literature Service System (SinoMed). Databases were searched for studies on the prevalence and influencing factors of myopia up to November 2024. The inclusion of studies was determined by consultation after independent screening by 2 investigators, and the studies were assessed for literature quality using the Agency for Healthcare Research and Quality (AHRQ) evaluation criteria, and Meta-analysis was performed using Stata 18.0 software.

A total of 33 papers were included, with 768 813 cases of myopia. Meta-analysis showed that the prevalence of myopia among children and adolescents in China was 58% (95%CI=54%-62%), with the prevalence of myopia among females (OR=1.41, 95%CI=1.21-1.64), high school (OR=3.59, 95%CI=1.17-10.97), and senior grades (OR=1.53, 95%CI=1.33-1.77), urban (OR=2.12, 95%CI=1.29-3.48), one or both parents myopic (OR=1.88, 95%CI=1.78-1.99; OR=2.45, 95%CI=1.97-3.06), overweight or obese (OR=1.74, 95%CI=1.63-1.85), and incorrect reading and writing posture (OR=1.35, 95%CI=1.14-1.60), reading books or electronic screens while lying down or lying on their stomachs (OR=1.17, 95%CI=1.03-1.33), terminal video screen use >2 h per day (OR=1.29, 95%CI=1.15-1.44), and of outdoor activity <2 h per day (OR=1.41, 95%CI=1.10-1.80), average daily sleep time ≤8 h (OR=1.71, 95%CI=1.28-2.30), and attending cultural tutorial classes for ≥2 h in the past week (OR=1.27, 95%CI=1.12-1.42) were the risk factors for myopia in children and adolescents (P<0.05) ; doing eye exercises (OR=0.79, 95%CI=0.64-0.98), preferring vegetables and fruits (OR=0.84, 95%CI=0.76-0.92), and having outdoor activities during recess (OR=0.75, 95%CI=0.74-0.77) were protective factors for myopia in children and adolescents (P<0.05) .

The prevalence of myopia among children and adolescents in China is high, and females, high school, urban, family history of myopia, obesity, eye habits and conditions, sleep time, and insufficient outdoor activities are the main risk factors for myopia among children and adolescents, which should be improved to increase the attention to myopia among children and adolescents, and to provide early identification of myopia and intervention for children and adolescents, so as to reduce the prevalence of myopia and improve the quality of life of children with myopia.