A November 2024 study examined visual acuity in 9,094 elementary and junior high school students in Wuqia County, western China. The overall prevalence of reduced visual acuity was 21.52%, while it was significantly higher in girls (26.62%) than in boys (16.90%). The incidence of vision problems increased significantly with higher grades - from 8.10% in the first grade to 31.03% in the ninth grade. Urban elementary schools showed a higher prevalence of reduced visual acuity (21.33%) compared to rural schools (15.32%). Multivariate analysis identified three main factors associated with increased risk: higher grade level, female gender, and location of the school in an urban environment. The results of the study highlight the need for targeted interventions and public health policies to improve eye care in the mountainous regions of western China.