Objective To investigate the conditions of glasses wearing and vision correction among primary and secondary school students in Henan province, thus providing a theoretical basis for the prevention and control of myopia.

Methods From September to October 2023, a stratified cluster sampling method was adopted to select 351 497 primary and secondary school students from 158 counties and districts in Henan province for vision screening and questionnaire surveys. The vision correction condition was analyzed according to different demographic characteristics and influencing factors.

Results In 2023, the glasses-wearing rate among primary and secondary school students in Henan province was 30.24% (106 292/351 497). The rate among girls was 33.63% (56 473/167 906), which was higher than that among boys at 27.14% (49 819/183 591). The rate in urban areas was 33.35% (44 597/133 707), higher than that in suburban and rural areas at 28.33% (61 695/217 790). The glasses-wearing rate showed an increasing trend as the phase of studying increased (P < 0.05). Among students with myopia, 50.34% (101 948/202 518) had their vision corrected with glasses, while the rate of uncorrected or undercorrected vision reached 64.42% (130 469/202 518). The rate of uncorrected or undercorrected vision was higher among boys at 65.71% (65 789/100 113) than among girls at 63.16% (64 680/102 405). It was also higher in suburban and rural areas at 65.53% (80 322/122 579) than in urban areas at 62.73% (50 147/79 939). The rate of uncorrected or undercorrected vision showed a decreasing trend as the phase of studying increased (P < 0.05). Logistic regression analysis showed that self-assessment of no myopia (OR = 3.940, 95%CI: 3.122–4.973), sometimes wearing glasses (OR = 2.157, 95%CI: 2.090–2.227), never wearing glasses (OR = 2.592, 95%CI: 2.488–2.701) were associated with an increased rate of uncorrected or undercorrected vision among myopic students. In contrast, visual acuity examination 1–2 times (OR=0.593, 95%CI: 0.557–0.631) and 3 times or more (OR=0.494, 95%CI: 0.462–0.529) in the past year, optometry only (OR = 0.616, 95%CI: 0.586–0.648), pupil dilation exam only (OR = 0.733, 95%CI: 0.669–0.797), optometry and pupil dilation exam (OR = 0.593, 95%CI: 0.563–0.624) before optometry were associated with an decreased rate of uncorrected or undercorrected vision among myopic students.

Conclusions The glasses-wearing rate is not high among primary and secondary schools in Henan province, while the rate of uncorrected or undercorrected vision is high among in myopic students. It is necessary to strengthen the publicity and education of scientific vision correction.