Abstract
Myopia prevalence is influenced by environmental factors including heritability and social disadvantage. The current prevalence of myopia among disadvantaged school children in Australia has not been reported. Therefore, this study analyses refractive data for children from rural and outer suburban areas. The records of 4,365 children aged 6-15 visiting a city-based government-school respite care center during the years 2014/2016/2018 were analyzed for right eye non-cycloplegic spherical equivalent refraction (SER). The prevalence of myopia (SER≤-0.50D) was compared with historical data. The prevalence of myopia was 3.5%, 4.4% and 4.3% in 2014, 2016 and 2018, respectively. The prevalence of myopia increased with age (P<0.0001), but was not related to sex or year of testing (all P >0.05). The overall mean SER was 0.89±0.86D, 0.62±0.89D and 0.56±0.95 in 2014, 2016 and 2018, respectively. Mean SER was associated with year of testing, age (all P <0.0001) and sex (P = 0.03). Mean SER decreased slightly from 2014 to 2018 and demonstrated a significant shift towards less hyperopia with increasing age. Mean SER of females was higher than that of males and decreased faster than in males with age (P interaction = 0.03). Myopia prevalence increased with age. The mean SER decreased slightly from 2014 to 2018. Sex differences in the rate of change with age was observed. Compared with 40 years ago, the prevalence of myopia has doubled, but it remains significantly lower than in school children of a similar age living in established urban areas that are regarded as having a higher socioeconomic status.
Highlights
There is evidence that myopia is reaching epidemic proportions at a speed that suggests strong environmental influences [1]
The prevalence of astigmatism and sex differences were very similar across these two separate historic cohorts. In this retrospective cross-sectional audit, we evaluated 4365 disadvantaged Australian schoolchildren and showed that myopia prevalence increased with age and mean spherical equivalent refraction (SER) decreased slightly from 2014 to 2018
Other cross-sectional studies at different time points in different countries or areas showed that the prevalence of myopia among schoolchildren increased over time (Table 5) [7,13,14,16, 33,34,35,36]
Summary
There is evidence that myopia is reaching epidemic proportions at a speed that suggests strong environmental influences [1]. The absolute prevalence of myopia in Australia is much lower than in East Asian [14,15,16], United States [13] and Western Europe [17,18,19,20]. The evidence for an increasing prevalence of myopia in Australia is more questionable, due to the limited number of cross-sectional studies over time and the confounding effects of age-related emmetropization [21]. Studies at different time points are clearly required to quantify changes in the prevalence of myopia, for accurate assessment of the public health impacts and to assist with the development of preventive approaches
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