Abstract: Objective To investigate the refractive status of preschool children in Hanyang District of Wuhan and to analyze its associated factors,so as to provide scientific evidence for the early prevention and intervention of refractive error in children. Methods A cross-sectional study was conducted among 398 preschool children aged 3-6 years who underwent routine health examinations at the Hanyang District Health Center for Women and Children between September 2023 and February 2024.Binocular refractive status was measured using a SureSight handheld autorefractor.A structured questionnaire was used to collect information on demographic characteristics,visual habits,and dietary and nutritional status.Group differences were compared using the χ² test,and multivariate logistic regression analysis was performed to identify factors associated with refractive error. Results A total of 398 preschool children(796 eyes)were included in the study.The detection rate of refractive error was 13.1%.No statistically significant differences were observed in the prevalence of refractive error across age groups or between sexes(P>0.05).Multivariate logistic regression analysis showed that lower maternal education level(OR=1.621,95%CI:1.038,2.534)and a viewing distance of <50 cm when using computers or other electronic devices(OR=2.301,95%CI:1.200,4.414)were risk factors for refractive error.In contrast,regular vision examinations(OR=0.330,95%CI:0.176,0.618),always taking breaks from the screen during electronic device use(OR=0.252,95%CI:0.068,0.937),not watching television(OR=0.154,95%CI:0.025,0.933),absence of micronutrient deficiency in the past year(OR=0.268,95%CI:0.104,0.693),and absence of vitamin deficiency(OR=0.035,95%CI:0.003,0.384)were protective factors(all P<0.05). Conclusion The prevalence of refractive error among preschool children in Hanyang District of Wuhan remains relatively high.Maternal education level,electronic screen use behaviors,vision examination practices,and nutritional status may influence refractive status in preschool children.Strengthening vision screening programs,regulating electronic device use,and promoting balanced nutrition may help support healthy visual development in early childhood.

Key words: refractive status, influencing factors, preschool children