Objective This study aims to explore different visual development trajectories among Chinese elementary school students and their risk factors. Methods A longitudinal cohort study was conducted from 2024 to 2025, involving students from four grades (2020–2023) at a primary school in Chengdu, China. Participants underwent 10 waves of visual acuity examinations over the one-year period. Latent Class Growth Modeling (LCGM) was employed to classify visual acuity development trajectories. A comprehensive survey was administered to assess potential risk factors, and multinomial logistic regression was utilized to analyze the determinants of trajectory. Result Three distinct trajectories were identified: “moderate-initial rapid decline” (Class 1, n = 683), “high-initial stable” (Class 2, n = 267), and “low-initial slow decline” (Class 3, n = 184). Higher grade levels and maternal myopia were significant predictors of the low-initial slow decline trajectory. Reading posture, bedtime, and frequency of health education sessions were significant factors influencing visual development trajectories. Conclusion These findings highlight the importance of targeted, trajectory-based screening strategies in school settings. Early identification of high-risk subgroups—particularly those in higher grades with maternal myopia—may inform the development of precision interventions to mitigate myopia progression among Chinese primary school children.
Chen et al. (Tue,) studied this question.