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目的 分析河南省7 ～18岁中小学生1985-2014年视力不良状况及30年间变化,为制定视力不良防控政策及措施提供依据.方法 对1985-2014年河南省7次学生体质调研7～18岁中小学生视力数据进行分析.结果 2014年河南省中小学生视力不良率为55.10％,重度、中度、轻度视力不良率分别为32.30％、16.70％、6.10％,女生(58.40％)高于男生(51.90％);城市(61.10％)高于农村(49.10％);高中视力不良率(77.90％)高于初中(67.70％)和小学(37.60％).1985-2014年河南省中小学生视力不良率上升26.8％,上升幅度为94.7％,重度、中度上升幅度分别为122.8％、119.7％,轻度下降幅度为1.6％,男生上升幅度(100.3％)高于女生(89.0％),乡村上升幅度(119.2％)高于城市(80.8％),小学上升幅度(216.0％)高于初中(103.9％)和高中(57.1％).结论 河南省7～18岁中小学生视力不良率持续增长,男女生视力不良差异减小,乡村视力不良增长加快,并呈现低龄化趋势,应加强对乡村和小学健康干预措施.“,”Objective To analyze the prevalence and wend of poor eyesight among the students aged 7-18 years in Henan province between 1985 and 2014 and to provide evidences for prevention and control of poor eyesight in the population.Methods Data on vision examination for the students at ages of 7-18 years were extracted from the datasets of 7 waves of physical fitness survey among students in Henan province conducted between 1985 and 2014.Results Among the students surveyed in 2014,the overall prevalence rate of poor eyesight was 55.1％,with the higher rate for the girl students (58.40％) than the boy students (51.90％),the urban students (61.10％) than the rural students (49.10％),and the senior high school students (77.90％) than the junior high school students (67.70％) and the primary school students(37.60％);the prevalence rate of severely,moderately,and slightly poor eyesight were 32.30％,16.70％,and 6.10％,respectively.From 1985 to 2014,the prevalence rate of poor eyesight increased by 26.8％ for all the students surveyed,with an overall increasing ratio of 94.7％ and higher increasing ratios of 100.3 ％,119.2％,and 216.0％ for the boy students,rural students,and primary school students compared to those for the girl students (89.0％),urban students (80.8％),junior and senior higher school students (103.9％ and 57.1％),respectively.The increasing ratios for the prevalence of severely and moderately poor eyesight were 99.3％ and 119.7％;whereas the prevalence of slightly poor eyesight showed a decreasing ratio of 1.6％.Conclusion The prevalence rate of poor eyesight increased continuously among 7-18 years old students in Henan province between 1985 and 2014 and the prevalence rate increased more quickly among rural students and the students at younger ages;the gap in the prevalence rate between male and female students decreased.The results suggest that health education on eye hygiene should be strengthened among the students,especially among rural and primary school students.