Objective  To compare disparities in prevalence of poor vision and eyeglass wear between urban and rural students in western China, and to provide evidences for developing effective interventions on poor vision in the students.

  Methods  We conducted a survey on eyesight among 39 230 students aged 9 – 17 years randomly selected from 290 primary and middle schools in urban and rural regions of Shaanxi and Gansu province in western China between 2017 and 2018. Logistic regression analysis was used to explore differences in prevalence of poor vision and eyeglass wear between the urban and rural students.

  Results  The rural students had a poor vision prevalence rate of 46.45%, with a significantly lower risk of poor vision (odds ratio OR = 0.632, P < 0.001) compared to the urban students. For the students with poor vision, the eyeglass wear rate among the rural students was significantly lower than among the urban students (34.89% vs. 54.95%) and the rural students had a significantly lower likelihood of wearing eyeglass than the urban students (OR = 0.494, P < 0.001). Logistic regression analyses indicated that the girl students, junior students, the students with parental education of junior high school and above, and the students living with a mother being at home frequently were more likely to have poor vision and to wear eyeglass when having poor vision (P < 0.005 for all). The rate for all types of poor vision were significantly higher among urban students than among the rural students (P < 0.001).

  Conclusion  There are significant disparities in the prevalence rate of poor vision and eyeglass wear between rural and urban students in western China; both the poor vision rate and eyeglass wear when having poor vision are lower in rural students, suggesting that more rural students need to have their poor vision improved.