方法：采用分层整群随机抽样，抽取城乡结合部小学和初中，自制问卷调查学生3 572名，同时现场进行眼科常规检查及泪液分泌试验、泪膜破裂时间测定和角结膜荧光素染色三项检查，采用SPSS19.00软件对数据进行分析。

结果：本次调查中3 572名7 144眼对象中，视力不良总体人数为764名1 447眼，按眼数计算总体视力不良率为20.25%，其中小学视力不良率为14.08%，初中视力不良率为29.51%，初中视力不良率明显高于小学(P<0.05)； 干眼症总体人数为424例848眼，总体干眼症发生率为11.87%，其中小学干眼症发生率为5.14%，初中干眼症发生率为21.96%，初中干眼症发生率明显高于小学(P<0.05)； 有序多分类Logistic回归分析，结果显示初中、每天做作业时间1～3h及>3h、眼与书本距离<30cm，躺着看书、每天看电视玩电脑手机时间1～3h及>3h、干眼症和营养状况(肥胖和消瘦)是中小学生视力不良的影响因素(OR=3.862、1.164、1.210、1.212、1.315、1.319、3.040、1.110、1.057、1.141)。

结论：中小学生视力不良的影响因素多，其中干眼症是广州市城乡结合部中小学生视力不良的危险因素之一。

METHODS: We used stratified cluster random sampling, extracted the urban-rural fringe elementary school and middle school, gave out self-made questionnaire survey to 3572 students, at the same time, underwent ophthalmology routine inspection and tear secretion test, rupture time measurement and corneal and conjunctival fluorescein staining.

RESULTS: The overall number of poor vision was 764 people(1447 eyes), the overall poor vision was 20.25% counted by eye amount, the rate of poor vision in primary school was 14.08%, in junior high school was 29.51%, in junior middle school was significantly higher than that in primary school(P<0.05). The number of subjects with dry eyes was 424 cases(848 eyes), the overall incidence of dry eyes was 11.87%, among them the occurring rate of dry eyes in primary school was 5.14%, in junior middle school was 21.96%, which was significantly higher than that in primary school(P<0.05). Ordered multivariate Logistic regression analysis showed that junior high school, doing homework for 1-3h or >3h every day, eyes away from the book <30cm, lying down when reading books, watching TV or playing computer phone for 1-3h and >3h every day, dry eyes, and the nutritional status(fat or thin)were the risk factors of poor vision in primary and middle school students the(OR=3.862, 1.164, 1.210, 1.212, 1.315, 1.319, 3.040, 1.110, 1.057 and 1.141).

CONCLUSION: The risk factors of primary and middle school students vision is multifarious, dry eyes is a risk factor for poor vision of primary and middle school students in the urban-rural fringe of Guangzhou.