Author(s): CHEN, J., ZHANG, Y. , Institution: CHINA INSTITUTE OF SPORT SCIENCE, Country: CHINA, Abstract-ID: 735

INTRODUCTION:
Poor vision among children and adolescents is a growing global public health challenge, especially in highly urbanized regions. Long-term population-based surveillance is critical for identifying epidemiological trends and modifiable risk factors. This study investigated the prevalence, temporal trends, and influencing factors of poor vision among children and adolescents in Macao from 2005 to 2025.
METHODS:
Using stratified random sampling, 21,374 children and adolescents aged 6–18 years were selected from the Macao Citizen Physical Fitness Surveillance Database in 2005, 2010, 2015, 2020, and 2025. Descriptive statistics summarized visual status across survey years. Trend χ² tests assessed temporal changes in normal vision prevalence. Factors associated with poor vision were screened using univariate χ² tests, and statistically significant variables were entered into multivariable logistic regression models to identify determinants of mild, moderate, and severe poor vision. The significance level was set at α = 0.05.
RESULTS:
Between 2005 and 2025, the prevalence of normal vision among children and adolescents in Macao declined significantly from 39.7% to 26.4% (trend χ² = 185.3, P < 0.01), indicating a continuously increasing burden of poor vision. The prevalence of severe poor vision remained high, reaching 46.7% in 2025. Univariate analyses showed that sex, age, frequency and duration of physical education classes, extracurricular physical activity frequency, walking time to physical activity venues, and sleep duration were all significantly associated with poor vision (P < 0.05). Multivariable analyses revealed that physical education classes ≥3 days per week, class duration of 60–120 minutes, and extracurricular physical activity 5–7 days per week were protective against mild poor vision (OR = 0.50–0.56). Sleep duration of 8–10 hours was protective for moderate poor vision (OR = 0.49–0.59), while walking time >60 minutes to activity venues increased risk (OR = 1.51). For severe poor vision, extracurricular physical activity ≥3 days per week (OR = 0.58–0.65) and sleep duration of 9–10 hours (OR = 0.67) were protective, whereas older age (OR = 1.22) and longer walking time to activity venues (OR = 1.34) were risk factors.
CONCLUSION:
Visual health among children and adolescents in Macao remains poor, with persistently low normal vision prevalence over two decades. Insufficient physical activity, inadequate sleep, and limited accessibility to physical activity environments are key contributors. Targeted interventions should focus on school-age and adolescent populations by strengthening school-based physical education, improving community activity environments, and promoting adequate sleep through coordinated family–school–community strategies.