Trend of Myopia Incidence Among Adolescents (2018-2025) in Senior High School: A 3-Year Follow-Up Study in Multi-Region of China with Projections to 2030

PURPOSE To investigate the myopia incidence over the past eight years in senior high schools in China and predict its five-year trend. METHODS This study was a multi-regional 3-year follow-up study. A total of 5540 students aged 14-16 years (15.3±0.5 years) were enrolled nationwide from September 2015 to September 2022. Each student was tested for visual acuity and cycloplegic refraction and was followed up every year for a total three years. Historical data on refraction and myopia prevalence from 2018 to 2025 (Grade 2015 to 2022) were analyzed based on a log-linear regression model to predict the myopia incidence in the next five years (2026 to 2030). RESULTS From 2018 to 2025, the myopia incidence in total 5540 students of the past eight years was 24.51%. The myopia incidence reached a peak of 32.87% in 2020 while hitting a low of 13.20% in 2024. In the -0.25 to +0.50 D baseline refraction subgroup, the 3-year myopia incidence peaked at 31.6%. The incidence rate of myopia in the first year of senior high school was recorded at 1.36% (74 out of 5,440), rising to 4.49% (236/5,253) in the second year and 19.74% (969/4,908) in the third year, respectively.Predictions show myopia incidence dropping from 19.23% in 2026 to 16.06% by 2030. CONCLUSION China's recent myopia prevention and control have yielded results, with senior high school students' myopia incidence rate projected to decline over the next five years. Students with SER no higher than +0.50D still require more attention in myopia prevention.