The epidemiology of myopia in school children worldwide.

Abstract

AbstractPurposeBoth genetic and environmental factors play a role in the increasing prevalence of myopia. This modern rise mirrors the trend of children spending a considerable amount of time reading, studying or—more recently—being glued to computer and smartphone screens. The aim of this study is to present an update on the current epidemiology and risk factors for myopia in school children in different countries around the world.MethodologyPubMed and Medline were searched for the following keywords: prevalence, incidence, myopia, refractive error, risk factors, children and visual impairment. English language articles published between Jan 1, 2013 and Nov 30, 2018 were included in the study. Studies were critically reviewed for study methodology and robustness of data. Seventy‐nine studies were included in the review.ResultsPrevalence remains higher in Asia (60%) compared with Europe (40%) using cycloplegic refraction examinations. Studies reporting on non‐cycloplegic measurements show exceptionally high myopia prevalence rates in school children in East Asia (70%–80%) compared with North America (42.2%). Low prevalence under 10% was described in African and South American children. New risk factors, apart from outdoor time and near work exposure, such as dim light, the use of LED lamps for homework, low sleeping hours, reading distance less than 25 cm and living in an urban environment were described in recent studies.ConclusionsThe high rates of myopia prevalence among school children, especially Asian populations, are strongly influenced by particular lifestyle habits. Increase in outdoor time remains the best strategy to prevent myopia onset. Additional epidemiological studies should be carried out on implementation of public health strategies to tackle and avoid myopia onset. High‐risk populations with high myopia prevalence might need a combined approach of increased outdoor time, changes in near distance activities in preschool children and treatment to control myopia progression.