本研究目的在於了解影響台灣地區學齡前兒童近視發生及視力近視化之因素，以就讀於台灣地區公私立幼托園所且在2009年及2010年完成相同視力檢查之5-7歲幼童為樣本，運用追蹤回溯法，進行問卷調查，共完成1,108份資料收集，回收率為72.5％。結果歸納如下：
一、以左眼為例，學齡前幼童眼球平均屈光度，前測為＋0.98D、標準差1.00D；後測時為＋0.71D、標準差1.04D，都屬於輕度遠視，在性別上沒有顯著差異；近視罹患率，第一年為6.9%，第二年為 12.5%，女生比男生高；前後間隔一年的眼球屈光度平均增加為-0.27D、標準差0.36D，不同屈光類別在一年間眼球屈光度變化有顯著差異，其中近視的度數變化顯著大於正視及遠視者。任一眼近視發生率為7.64%、近視化比率為30.2%。
二、學齡前幼童在一年內有半數以上曾就醫，原因是幼托園所通知視力複查，且就醫之後，有半數以上能回診。其家長認為就醫的距離還不算遠。
三、學齡前幼童之家長防治幼童近視的行為，在「讀寫環境照明」、「讀寫姿勢不良之糾正」、「眼疾觀察與照顧」實踐程度較好；在「陪幼童到戶外運動」、「不提早讓幼童執筆寫字」、「近距離用眼30-40分鐘就讓他休息10分鐘」、「放學後不要讓幼童看電視」則實踐程度較差。
四、學齡前幼童每日近距離用眼時數平均為213分鐘、戶外活動時數為79.5分鐘、睡眠時數為9.4小時。近距離用眼時數最多的項目是看電視，平均每日76分鐘、其次是讀書寫字，平均每日65分鐘。
五、學齡前幼童近視發生與「年齡」、「父母任一方有近視」、「家庭社經地位」、「近距離用眼時數」有顯著關係；其中「年齡」、「家庭社經地位」、「父母任一方有無近視」、「近距離用眼時數」為主要預測變項，表示年齡越大者、父母任一方有近視者、家庭社經地位越低者、近距離用眼時數越多者，容易發生近視。父母任一方有近視者發生近視約為父母無近視者的4倍。
六、學齡前幼童視力近視化與「年齡」、「家庭社經地位」、「近距離用眼時數」有顯著關係。其基本變項、家長防治幼童近視之行為、個人用眼行為等變項能有效預測視力近視化現象，並解釋視力近視化總變異量之8.5%，其中「家庭社經地位」、「父母任一方有無近視」及「近距離用眼時數」為主要預測變項，顯示學齡前幼童的象家庭社經地位越低者、父母任一方有近視者及近距離用眼時數越多者，其視力近視化情形越為嚴重。
結論與建議：近視一旦發生其度數比非近視者容易惡化，而影響近視發生與近視化之因素與近距離用眼時數關係密切，建議教育與衛生主管單位應加強規劃多元化之課後活動，減少近距離用眼時間，並應進行近視防治縱貫性研究，監測近視發生與惡化之危險因子，對學齡前兒童施行特殊保護措施，預防早發性近視之發生。

The purpose of this study is to investigate the incidence of myopi and myopia progression among preschool children in Taiwan. Children aged 5 to 7 years from public and private kindergartens, who completed the same eye examination in 2009 and 2010, were chosen as the study sample. Retrospective and prospective study were applied to the follow-ups and questionnaire survey. Eye examination and questionnaire were administered in this study, with 1108 valid examinations and questionnaires and the response rate of 72.5％.
The major findings were as follows:
1). The mean refraction of children’s left eye was +0.98D (SD,1.00D) in the initial examination and +0.71D (SD,1.04D) in the follow-up examination. Both were slight hyperopia. There was no significant difference in gender. Myopia prevalence was 6.9% in the first year and 12.5% in the second year. There was higher myopia prevalence among girls. Between the two examinations,the mean refraction slight was howard myopia -0.27D (SD, 0.36D). Eyes with different refraction status experienced significantly different change of refraction. Myopic children had more change of refraction than emmetropic and hyperopic kids. Incidence of myopia and myopia progression rate of either eye were 7.64% and 30.2%, respectively.
2). Within a year, over 50% of preschool children visited doctors for eye disorder. The major reason for clinic visit was the notice of the follow-up eye examination given by kindergartens. The majority of preschool children made the follow-up visits after the first time. Parents did not consider the location of clinics.
3). Among parents’ preventative measures against myopia in children, “illuminating the reading and writing environment”, “correcting the improper reading and writing postures”, and “observing and taking care of eye disorder” were better practiced. On the other hand, “doing outdoor sports with children”, “preventing children from writing with pen in early age”, “taking a 10-minute rest after engaging in near work for 30 to 40 minutes”, and “prohibiting kids from watching TV after school” were less observed.
4). In average, preschool children devoted 213 minutes to near work, 79.5 minutes to outdoor activities, and 9.4 hours to sleeping each day. Watching TV (76 minutes per day) accounted for the biggest portion of the time, followed by writing and reading (65 minutes per day).
5). There was a significant relation between the incidence of myopia and “age”, “one myopic parent”, “social-economic status”, and “time for near work”. “Age”, “one myopic parent”, “social-economic status”, and “time for near work” were major predictive variables. In other words, those who with older age, one myopic parent, lower social/economical status, or more time for near work had a higher rate of myopia. Children with one myopic parent were 4 times more likely to develop myopia than children without myopic parents.
6). There was a significant relation between myopia progression and “age”, “social-economic status”, and “time for near work”. The basic variables of the subjects, the parents’ preventative measures against myopia in children, and the ways kids using eyes can effectively predict incidence of myopia and explain 8.5% of the myopia progression. “Age”, “one myopic parent”, “social-economic status”, and “time for near work” were major variables for prediction. Myopia progression was more severe among preschool children who had lower social-economic status, one myopic parent, or more hours of near work.
According to the aforementioned findings, this study provided some suggestions for educational and government insititutes and would be a reference to some researches of preschool children’s myopia prevention in the future.

中文部分
王亦榮（1991）。國民小學學生視力狀況與生活習慣之研究。特殊教育與復健學報，1，133-180。
王藹侯、施永豐（1992）。近視的原因-臨床觀察及動物實驗。醫學繼續教育，2， 901-904。
內政部兒童局（2001）。護眼小百科。彰化縣幼兒教保學會。
行政院衛生署（2004）。幼稚園、托兒所兒童視力及斜弱視篩檢成效之評估。（計畫編號：DOH92-HP-1304）。
行政院衛生署（2009）。幼童近視防治親子手札。台灣眼科防盲教育研究依學會主編。
全國幼教資訊網（2009）。幼托園所名稱。取自2009年2月1日。http://www.ece.moe.edu.tw/admin/search/qsearch.html
宋湖仙、史麗珠、李建興、董曉青（2000）。國小學童眼球生長狀況之初報：基隆安樂社區眼位及視力調查。中華民國眼科醫學會雜誌，39，516-523。
沈秉衡（2001）。幼兒視力發育與檢查要領。載於中華眼科醫學會編，兒童視覺診療工作指引，3-7。
吳國揚、許明木、黃文龍、王蕙珠、陳振武（1991）。高雄市幼童之眼屈光要素四年之縱向研究。Kaohsiung J Med Sci，7，120-125。
吳淑芬、林隆光（1991）。幼兒視力篩檢法的臨床評估。中華民國眼科醫學會會刊，30，126-132。
吳妙純（2002）推動學校衛生教育經驗談學童視力保健。學校衛生。40，83-92。
兒童福利聯盟文教基金會（2010）。台灣學齡前幼童收看電視現象調查報告，2010.2.14。取自http://www.children.org.tw/news.php?id=2449。
林隆光、黃淑貞（1994）。台灣地區學齡前幼童視力篩檢示範推廣前驅計畫。行政院衛生署（計畫編號：DOH83- HP- 060-3M12）。
林隆光（1996）。近視病因發展史。台灣醫界，40，13-14。
林隆光（1999）。學幼童視力及立體感篩檢工作手冊。教育部印行。
林隆光（2006）台灣學童近視的流行病學研究：二十年的回顧。台北市醫師公會會刊，50，1-9。
林隆光、吳淑芬、王旭峰（1996）。台灣地區幼兒視力障礙之原因及其流行率之分析研究。行政院衛生署（計畫編號：DOH85- HP- 026-3M11）。
林隆光、施永豐、陳建仁、侯平康、李隆安、蔡忠斌（1996）。台灣地區六至十八歲中學童眼屈光狀態之流行病學研究（第四次）。行政院衛生署國民健康局（計畫編號：DOH84-ＴＤ-059）。
林隆光、施永豐、蕭朱杏、蔡紫薰、吳淑芬、陳家玉、謝蔭珮（2006）。台灣地區六至十八歲屈光狀況之流行病學調查研究（第六次）。行政院衛生署國民健康局（計畫編號：DOH95-HP-1315）。
李淑美、王新亞、瞿錦春（1990）。高度近視小孩之屈光狀態。中華民國眼科醫學會會刊，29，14-19。
施永豐（1996）。近視的藥物治療。台灣醫界，40，15-21。
施永豐（2001）。近視防治指引。載於中華眼科醫學會編，兒童視覺診療工作指引，19-26。
施永豐（2004）。國內外屈光問題相關研究文獻探討-近視流行病學及防治篩檢文獻回顧。行政院衛生署國民健康局 2004 年委託實証回顧研究。
施永豐、林隆光、吳淑芬（2010）。學齡前兒童近視及其他視力現況調查計畫。行政院衛生署國民健康局（計畫編號：DOH98-HP-1305）。
梁有松、賴盈州、駱朝陽、陳德照（1984）。國校學童眼睛檢查的初步結果報告。中華民國眼科醫學會會刊，23，1-7。
許明木（1991）。學童近視之原因探討（Ⅰ）。台灣醫界，35，45-46。
許明木、黃文龍、陳振武、王蕙珠（1984）。高雄市幼稚園幼童之眼屈光要素之研究。中華民國眼科醫學會會刊，23，8-13。
陳世真、程景煜（2009）。台灣的視網膜病變。中眼醫誌，48，237-244。
萬明美（2000）中途失明成人致盲原因及適應歷程之研究。特殊教育研究學刊，19，59-78。
陳南元、陳振武、黃文龍、林昌平、李秋忠（1984）。花蓮縣秀林鄉山地國小學童之眼屈光狀態調查。中華民國眼科醫學會會刊，23，14-19。
陳政友（2001）。學童視力保健之效果實驗研究報告。教育部委託中華民國學校衛生學會（計畫編號：MOE16-89047837）。
陳政友、沈希哲、劉婉柔、盧玉玫、謝雅萍（2009）。國小學童家長近視預防親職教育介入成效研究。健康促進與衛生教育學報，32，1-23。
陳建仁 (1996)。近視的流行病學。近視的治療。台灣醫界，40，14-15。
陳建仁（1999）。流行病學方法綜論。載於陳建仁編，流行病學：原理與方法（第一章）。台北：聯經。
黃美溶(2003)。幼童近視與父母的知識態度行為相關因素探討。中國醫藥學院醫學研究所碩士論文。
黃淑貞、洪文綺、陳曉玟（2004）。家庭因素和學業表現對我國國小學童視力保健與運動行為之影響。衛生教育學報，21，1-17。
教育部（2001）。把eye找回來。教育部編印。
教育部（2009）。視力保健Q＆A。台灣眼科防盲教育研究醫學會主編。
教育部（2005）。學童視力保健工作手冊。中華民國學校衛生學會主編。
彭秀英（2002）淺談國民小學視力保健工作實務。學校衛生護理，13-14，136-147。
彭秀英（2010）影響學齡前兒童之家長實施幼童近視防治行為之相關因素探討。學校衛生，57，21-38。
萬明美（2000）。中途失明成人致盲原因及適應歷程之研究。特殊教育研究學刊，19，59-78。
張雅芳（2004）。台北市學齡前幼童八十八年至九十二年視力篩檢結果之研究。國防醫學院公共衛生學研究所碩士論文。
劉乃昀(2005)。臺北市家長對學童採取近視防治行為及其相關因素研究—健康信念模式之應用。國立台灣師範大學衛生教育所碩士論文。
劉介宇、洪永泰、莊義利、陳怡如、翁文舜、劉季鑫、梁賡義(2006)。台灣地區鄉鎮市區發展類型應用於大型健康調查抽樣設計之研究。健康管理學刊，4，1-22。
劉秀雯（2008）。臺北市學齡前幼童近視防治模式之長期追蹤研究。行政院衛生署委託臺北市立聯合醫院眼科研究計畫（計畫編號：DOH96-HP-1309）。
劉婉柔（2004）。國小學童學習壓力及用眼行為與近視相關之研究。國立臺灣師範大學衛生教育研究所碩士論文。
鄭永豐（2007）。e世代台灣學童近視危險因子之探討。國立台灣大學公衛學院衛生政策與管理研究所碩士論文。

英文部分
Angi, M.R. , Forattini, F., Segalla, C. & Mantovani, E.(1996). Myopia evolution in pre-school children after full optical correction.Strabismus,4,145-157.
Bullimore, M. A. (1992). Low Vision Aids for Near Vision. Presented at Santa Clara Optometric Society. San Jose, CA.
Ciner, E.B.,Schmidt, P.P., Orel-Bixler, D., Dobson, V., Maguire, M., Cyert, L., Moore, B.& Schulz, J.(1998). Vision screening in the preschool child: Evaluating the past, looking toward the future. Investigative Ophthalmology & Visual Science, 75, 571-584.
Ciner E., Dobson V., Schmidt P., Allen D., Maguire M., Cyert L., Moore B. & Schulz J.（1999）. A survey of vision screening policy of preschool children in the United State. Survey of Ophthalmology, 43, 445-457.
Dayan,Y.B., Levin, A., Morad, Y., Grotto, I., Ben-David, R., Goldberg, A., Onn, E., Avni, I., Levi, Y.& Benyamini, G. (2005). The changing prevalence of myopia in young adults: a 13-year series of population-based prevalence surveys. Investigative Ophthalmology & Visual Science,46, 2760-2765.
Ehrlich, M.I., Reinecke, R.D. & Simons, K.(1983).Preschool vision screening for amblyopia and strabismus. Programs, methods, guidelines. Survey of Ophthalmology, 28, 145-163.
Fan, D.S.,Li, K.K. & Lam, D.S.(1999). Retinal complications after cataract extraction in patients with high myopia. Ophthalmology 106, 688-691.
Fan, D.S., Cheung, E.Y., Lai, R.Y., Kwok, A.K. & Lam, D.S.(2004). Myopia progression among preschool Chinese children in Hong Kong. Annals Academy of Medicine Singapore,33,39-43.
Fan, D.S., Lam, D.S., Wong, T.Y.,Islam, M., Saw, S.M., Cheung, A. Y. & Chew, S.(2005). The effect of parental history of myopia on eye size of pre-school children：a pilot study. Acta Ophthalmologica, 83, 492-496.
Giordano, L., Friedman, D.S., Repka, M.X., Katz, J., Ibironke, J., Hawes, P. & Tielsch, J.M.(2009). Prevalence of refractive error among preschool children in an urban population: the Baltimore Pediatric Eye Disease Study. Ophthalmology. 116, 739-746.
Grosvenor, T.(1987). A review and a suggested classification system for myopia on the basis of age-related prevalence and age of onset. America Journal of Optometry and Physiological Optics,64, 545-554.
Hollingshed, A. B. (1957). Two Factor Index of Social Position. New Haven: Mimea-graphed.
Ip, J. M., Rose, K. A., Morgan, I. G., Burlutsky, G.& Mitchell, P.(2008). Myopia and the urban environment: Findings in a sample of 12-Year-Old Australian school children. Investigative Ophthalmology & Visual Science, 49, 3858-3863.
Ip, J. M., Saw, S.M.,Rose, K.A., Morgan, I.G., Kifley, A., Wang, J. J.& Mitchell, P.(2008). Role of near work in Myopia: findings in a sample of Australian school children. Investigative Ophthalmology & Visual Science, 49, 2903-2910.
Jacobsen, N., Jensen, H. & Goldschmidt, E.(2007). Prevalence of myopia in Danish conscripts. Acta Ophthalmol Scandinavica, 85, 165-170.
Jones, L.A., Sinnott, L.T., Mutti, D. O., Mitchell, G. L.,Moeschberger, M. L. & Zadnik, K.(2007). Parental history of Myopia, sports and outdoor activities, and future Myopia. Investigative Ophthalmology & Visual Science, 48, 3524-3532.
Krejcie, R. V., & Morgan, D. W. (1970). Determining sample size for research activities. Educational and Psychological Measurement, 30, 607-610.
Krishnaiah, S., Srinivas, M., Khanna, R.C.& Rao, G.N.(2009). Prevalence and risk factors for refractive errors in the South Indian adult population: The andhra pradesh eye disease study. Clinical Ophthalmology, 3, 17-27.
Law, N.W., Chew, S.J., Ritch, R., Thompson, H.W.& Beuerman, R.W. (1992). Survey of refraction in a Chinese population shows that myopia severity can be predicted from its age of onset. Investigative Ophthalmology & Visual Science,33,709.
Lin, L.L.K., Shih, Y.F., Hsiao, C.K., Chen, C.J., Lee, L.A.& Hung, P.T.(2001). Epidemiologic study of the prevalence and severity of myopia among schoolchildren in Taiwan in 2000. Journal of the Formosan Medical Association, 100, 684-691.
Ling, S.L., Chen, A.J., Rajan, U.& Cheah, W.M.(1987). Myopia in ten year old children- a case-control study. Singapore Medicine Journal, 28, 288-292.
Olavi, P. & Lyyra, A.L.(1993).Myopia and Myopic progression among schoolchildren：a three-year follow-up study. Investigative Ophthalmology & Visual Science,34, 2794-2802.
Ojaimi, E., Rose, K.A., Smith, S., Morgan, I.G., Martin, F.J.& Mitchell, P.(2005). Methods for a population-based study of myopia and other eye conditions in school children: the Sydney myopia study. Ophthalmic Epidemiology, 12, 59-69.
Ojaimi E., Rose K.A.& Morgan I.G..(2005). Distribution of ocular biometric parameters and refraction in a population-based study of Australian children. Investigative Ophthalmology & Visual Science, 46, 2748-2754.
Resnikoff, S.,Pascolini, D., Etya’ale, D., Kocur, I., Pararajasegaram, R., Pokharel, G. & Mariotti, S. P.(2004).Global data on visual impairment in the year 2002, Bulletin World Health Organization, 82.
Rose, K. A., Ian, G., Smith, M.W., Burlutsky, B.G., Mitchell, P.& Saw, S.M.(2008). Myopia, lifestyle, and schooling in students of Chinese ethnicity in Singapore and Sydney. Archives of Ophthalmology, 126, 527-530.
Rose, K.A., Morgan, I.G., Ip, J., Kifley, A., Huynh, S., Smith, W. & Mitchell, P.(2008). Outdoor activity reduces the prevalence of myopia in children. Ophthalmology,115, 1279-1285.
Tan, G. J., Ng, Y. P., Lim, Y. C., Ong, P. Y., Snodgrass, A. & Saw, S. M.(2000).Cross-sectional study of near-work and myopia in kindergarten children in Singapore.Annals of the Academy of Medicine Singapore, 29, 740-744.
Tan, N.W.H., Saw, S.M., Lam, D.S.C., Cheng, H.M., Rajan, U., Chew, S.J.(2000).Temporal variations in myopia progression in Singaporean children within an academic year. Investigative Ophthalmology & Visual Science, 77, 465-472.
Tasman, W., Jaeger E. A. (1998). Duane’s clinical ophthalmology, Philadelphia:Lippincott Williams & Wilkins.
Tong, L. M., Saw, S. M., Chua, W., Tan, D., Koh, A., Cheng, B., Yeoh, I., Wong, E. ＆ Scorm.(2003).Posterior segment changes in myopic children from a Singapore school cohort. Investigative Ophthalmology & Visual Science, 44, 799.
Saw, S. M., Chan, B., Seenyen, L., Yap, M., Tan, D.& Chew, S. J.(2001). Myopia in Singapore kindergarten children. Optometry, 72, 286-291.
Wang, T. J., Chiang, T. H., Wang, T. H., Lin, L. L.& Shih, Y. F.(2009). Changes of the ocular refraction among freshmen in national Taiwan university between 1988 and 2005, Eye, 23, 1168-1169.