Prevalence Of High Myopia Research Articles

Association between weekend catch-up outdoor duration and prevalence of myopia: evidence from a cross-sectional, multi-center study in China

BackgroundThis study aimed at investigating the relationship between the weekend catch-up outdoor duration (WCOD) and prevalence of myopia among students in China.MethodsThis cross-sectional study recruited participants in 107 schools (six cities, 30 districts) from China from May to June 2021. Demographic characteristics (age, grade, sex, ethnicity, BMI, resident, and parents’ myopia), optically habits (bad writing habits, working/studying time per day, continuous working/studying time per day, and screen time per day) and outdoor duration (weekday and weekend) were obtained from questionnaire. WCOD was defined as outdoor time 1 h longer on weekends than on weekdays. Spherical equivalent (SE) of refractive error were measured with non-cycloplegic refraction. Adjusted multivariate logistic regression analysis was performed to evaluate the relationship between WCOD and prevalence of myopia.ResultsStudents with myopia had shorter WCOD compared with those without myopia (P < 0.001). Adjusted multivariate logistic regression analyses showed negative associations between WCOD and prevalence of myopia in Chinese students, especially in students with WCOD of 2–3 h (OR = 0.577, P < 0.001) and 3–4 h (OR = 0.571, P = 0.004) when the weekday outdoor duration was 0.5–1 h, as well as students with WCOD of 2–3 h (OR = 0.614, P = 0.003) when the weekday outdoor duration was 1–2 h. Similar results were observed in students with high myopia. Students with high myopia had shorter WCOD compared with those without high myopia (P = 0.001). Negative associations between WCOD and prevalence of high myopia were significant in students with WCOD of 1–2 h when the weekday outdoor duration was < 0.5 h (OR = 0.585, P = 0.007) and 0.5–1 h (OR = 0.537, P = 0.018).ConclusionOur study, for the first time, reported that a WCOD have a potential to reduce the prevalence of myopia and high myopia in Chinese students.

Is the Change in Prevalence of High Myopia Compared to That of Myopia Really Disproportionate?

It has been noted that, at higher prevalences, the rate of change in the prevalence of high myopia seems to be disproportionately greater compared with the rate of change in the prevalence of myopia. A simple, evidence-based explanation for this relationship is offered. Using a convenience sample of 41 datasets with prevalence estimates for at least two refractive error thresholds (e.g., -0.50 and -6.00 D) the common slope of the logit vs. refractive threshold was applied to model expected rates of high myopia across the myopia prevalence range and the corresponding ratio of change in high myopia to myopia prevalence. The logit of high myopia is related linearly to the logit of myopia. The ratio of increase in high myopia prevalence to that for myopia prevalence increases with underlying prevalence. For example, an increase in myopia prevalence from 19% to 20% is modelled to be accompanied by a 0.1% increase in the prevalence of high myopia from 1.55% to 1.65%-a ratio of 0.1. Conversely, an increase in myopia prevalence from 79% to 80% is predicted to result in a 1% increase in the prevalence of high myopia from 20.6% to 21.6%-a ratio of 1.0. The increase in the prevalence of high myopia compared with that of myopia as the latter increases is merely a function of the underlying nature of refractive error probability distributions and requires no further investigation as to its origin. This study shows how the prevalence of myopia and high myopia are inter-related. A widespread effort to slow myopia progression will affect the prevalence of high myopia but not myopia in general. In contrast, efforts to delay myopia onset will affect both.

Effects of Insufficient Sleep on Myopia in Children: A Systematic Review and Meta-Analysis.

Myopia is increasingly prevalent in children. Its association with insufficient sleep has been studied, yielding inconsistent findings. This review aims to assess the association of insufficient sleep with myopia and myopia-related refractive parameters in children. A total of 657 articles were identified, of which 40 were included in the systematic review and 33 were included in the meta-analysis. Results showed that insufficient sleep was significantly associated with an increased prevalence of myopia (odds ratio [OR] = 1.59; 95% confidence interval [CI] = 1.31, 1.95; I 2 = 99%), and an increased prevalence of high myopia (OR = 3.36; 95% CI = 1.26, 9.00; I 2 = 96%). Shorter sleep duration was significantly linked to faster changes in axial length (AL) (β = 0.05; 95% CI = 0.02, 0.08; I 2 = 0%). However, correlation between insufficient sleep and the incidence of myopia, spherical equivalent refraction, corneal curvature radius (CR) and AL/CR were insignificant. Moreover, the effect of insufficient sleep on premyopia and astigmatism was not well-studied. The results of this study suggest that insufficient sleep may be an important risk factor for the development of myopia in school-aged children. Therefore, in addition to ensuring sufficient outdoor activities and reducing near work, it is necessary to inform children and parents about the importance of adequate sleep to mitigate the risk of myopia.

Developmental characteristics and control effects of myopia and eye diseases in children and adolescents: a school-based retrospective cohort study in Southwest China

ObjectivesTo characterise the prevalence of myopia and eye diseases among school adolescents and children in Southwest China, and to evaluate the effectiveness of myopia control tools.DesignRetrospective cohort study.SettingAcross 95 basic...

High myopia: Reviews of myopia control strategies and myopia complications.

Myopia and especially high myopia are recognised as major public health concerns. Although the prevalence of high myopia in young children is low, 10-20% of high school children in Asia have high myopia, with many still progressing, and one in three patients with high myopia develop visual impairment with age. Most participants in myopia control studies have low and moderate myopia; relatively little is known about myopia control in high myopia. Literature searches were undertaken in MEDLINE and EMBASE to identify publications in English, investigating (Aim 1) the efficacy of myopia control strategies (environmental, pharmacological and optical) in high myopia (≤-6.00 D) and (Aim 2) the complications of high myopia using keywords. Outcomes included change in spherical equivalent refractive error (SE) and/or axial length (AL) to evaluate progression in high myopia. Aim 1: Twelve studies were identified that reported the efficacy of optical and pharmacological (none on environmental) interventions on AL and SE for high myopia control. A statistically significant reduction in progression of SE and AL in high myopes was reported with 1% and 0.5% atropine. Defocus Incorporated Multiple Segment spectacle lenses had lower efficacy in slowing high myopia progression compared to moderate and low myopia. Ortho-K lenses were equally effective in reducing myopia progression in low, moderate and high myopia. Aim 2: Myopic patients have an increased risk of myopic macular degeneration, retinal detachment, cataract and glaucoma, with the risk increasing with the level of myopia. High myopia has significant effects on quality of life, risk of pathological complications and vision impairment. Young children, excluding those with some syndromic associations, who are fast progressing moderate and high myopes require early intervention and close monitoring. Further research investigating the efficacy of myopia control strategies in highly myopic patients, both independently and through combination treatments, are necessary.

Prevalence and associated factors of myopia among adolescents aged 12–15 in Shandong Province, China: a cross-sectional study

Myopia is a growing concern worldwide, especially among adolescents. This study aimed to investigate the prevalence and associated factors of myopia in adolescents aged 12–15 in Shandong Province, China. This cross-sectional study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines and involved stratified random cluster sampling of 128,678 students from 186 middle schools across 17 cities in Shandong Province. Data collection was conducted from March to April 2024. We excluded students with organic eye diseases, abnormal binocular vision functions, or a history of eye injuries or surgeries. Myopia was assessed using the standard logarithmic visual acuity chart and autorefractor without inducing ciliary muscle paralysis. A comprehensive questionnaire survey was conducted to gather demographic characteristics and daily life behaviors. With the chi-squared test for univariable analysis and multivariable logistic regression for identifying significant factors. This study included 126,375 participants, with a gender distribution of 51.02% male and 48.98% female. The overall prevalence of myopia was 71.34%. Higher prevalence was observed in girls (72.26%) compared to boys (70.45%), and the prevalence increased with age, peaking at 73.12% in 15-year-olds. Urban residents had a higher prevalence (71.86%) than rural (70.39%). Factors such as increased frequency of eye usage while lying down or leaning forward, frequent use of eyes while walking or riding in a car, prolonged screen time, and extended homework duration were associated with higher odds of developing myopia. Conversely, higher frequency of outdoor exercise, maintaining proper posture during reading and writing, greater distance from eyes to screen, and longer sleep duration were associated with lower odds. Additionally, female gender, older age, urban residence, and parental history of myopia increased the risk. The high prevalence of myopia among adolescents in Shandong Province was influenced by a combination of demographic, behavioral, and environmental factors. The study highlighted the importance of lifestyle modifications, such as increasing outdoor activities and maintaining proper visual habits, limiting the duration of screen exposure and homework sessions, and extending sleep duration, to mitigate the risk of developing myopia. These findings underscored the need for targeted public health interventions and educational campaigns to address this significant public health issue.

Socioeconomic disparities and green space associated with myopia among Chinese school-aged students: A population-based cohort study.

There is increasing evidence on the link between environmental factors and myopia in children and adolescents, yet with inconsistent conclusions. We investigated the associations between socioeconomic inequalities and green space with myopia in school-aged students participating in the Tianjin Child and Adolescent Research of Eye (TCARE) study. We obtained data from a population-based dynamic cohort study conducted in Tianjin, China, in 2021 and followed up in 2022. We included 1 245 271 participants from 16 districts with an average age of 11.6 years (standard deviation = 3.3) in our analysis. We synthesized their area-level SES through a prediction model that combined economic, educational, and health care variables and assessed the greenness levels surrounding the school using the Normalized Difference Vegetation Index (NDVI) based on data obtained through satellite remote sensing. We performed generalised linear mixed effects analyses for each myopia outcome separately, with adjustments for students' sex, years of education completed, and the school's geographical location. We observed that students living in low SES areas had the highest prevalence of myopia (60.7%) in the last screening in 2022, as well as a higher incidence of one-year myopia (26.4%) compared to those residing in middle SES areas (22.7%). With a 0.1 increase in the 250, 500, and 1000 m buffer NDVI, the prevalence of myopia dropped by 6.3% (odds ratio (OR) = 0.937; 95% confidence interval (CI) = 0.915, 0.960), 7.7% (OR = 0.923; 95% CI = 0.900, 0.946), and 8.7% (OR = 0.913; 95% CI = 0.889, 0.937), respectively. The interaction analysis showed that low SES and low greenness exacerbate the prevalence of myopia. Findings from longitudinal analyses consistently demonstrated a correlation between higher values of NDVI and a slower progression of myopia. These findings remained robust across sensitivity analyses, including for variables on parental myopia and students' behaviors. Exposure to green spaces could play a crucial role in slowing the progression of myopia among school-aged students. Myopia control policies should prioritise young populations residing in low SES areas with limited access to green spaces, as they face the highest potential risks.

Investigating the correlation between genotype and phenotype in Prader-Willi syndrome: a study of 45 cases from Brazil

BackgroundPrader-Willi syndrome (PWS) is a genetic disorder characterized by abnormalities in the 15q11-q13 region. Understanding the correlation between genotype and phenotype in PWS is crucial for improved genetic counseling and prognosis. In this study, we aimed to investigate the correlation between genotype and phenotype in 45 PWS patients who previously underwent methylation-sensitive high-resolution melting (MS-HRM) for diagnosis.ResultsWe employed methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) and Sanger sequencing, along with collecting phenotypic data from the patients for comparison. Among the 45 patients, 29 (64%) exhibited a deletion of 15q11-q13, while the remaining 16 (36%) had uniparental disomy. No statistically significant differences were found in the main signs and symptoms of PWS. However, three clinical features showed significant differences between the groups. Deletion patients had a higher prevalence of myopia than those with uniparental disomy, as well as obstructive sleep apnea and an unusual skill with puzzles.ConclusionsThe diagnostic tests (MS-HRM, MS-MLPA, and Sanger sequencing) yielded positive results, supporting their applicability in PWS diagnosis. The study’s findings indicate a general similarity in the genotype-phenotype correlation across genetic subtypes of PWS.

Association between Near Work, Physical Activities and Myopia in Korean Adults During COVID-19 Outbreak

ABSTRACT Purpose This study investigated the relationship between near work hours and myopia in Korean adults. Methods We used data from the 2021 Korean National Health and Nutrition Examination Survey. Associations between near work time, physical activity, and myopia were assessed using chi-square tests and multiple logistic regression analyses. Results The overall prevalence of myopia was 60.2% in adults aged 19–59 years. The prevalence of myopia was 46.2% for individuals who used smart devices for less than one hour per day, while it was 68.0% for those who used smart devices for more than four hours. In the multiple logistic regression analysis, the odds ratio (OR) for myopia was significantly higher among individuals using smart devices for 3 hours (OR = 1.55, 95% CI = 1.08–2.23) or more than 4 hours (OR = 1.75, 95% CI = 1.27–2.42), compared to users with less than 1 hour of usage. Regarding sitting time, the OR for myopia was significantly higher in individuals who sat for more than 12 hours (OR = 1.66, 95% CI = 1.05–2.61) compared to those who sat less than 4 hours. Conclusion This study found that near work and sitting times were positively associated with myopia. Given the high prevalence of myopia and its implications for serious eye diseases, it is essential to implement measures to manage myopia. Considering the increased near work hours resulting from the COVID-19 pandemic, it is necessary to adopt supplementary measures, such as ensuring sufficient rest time for the eyes and adjusting the brightness of lights, to improve eye health.

Systematic review and meta-analysis of the prevalence of myopia among school-age children in the Eastern Mediterranean Region.

The recent increase in myopia is a major public health concern worldwide, including in the Eastern Mediterranean Region (EMR). To provide data on the prevalence of myopia among school-age children in the EMR. This study was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) protocol. We searched the Web of Sciences, Scopus, Index Medicus for the Eastern Mediterranean Region, ProQuest, PubMed, and Medline for studies on the prevalence of myopia in the EMR published from January 2000 to May 2022. The data were analysed using MedCalc version 19.6.1 and myopia was defined as refractive error ≥ 0.50 D. The overall pooled prevalence of myopia was estimated using a random-effects model and its associated 95% confidence intervals. The meta-analysis included 27 quality-assessed studies from 13 countries among 51 111 school-age children. The overall pooled prevalence of childhood myopia from 2000 to 2022 was 5.23%, which was significantly higher among females than males (4.90% vs 3.94%). The prevalence of myopia was significantly higher among children aged 11-17 years than among those aged 5-10 years (7.50% vs 3.90%). There was a higher prevalence of myopia with cycloplegic refraction than noncycloplegic refraction (5.95% vs 3.73%). There was highly significant heterogeneity between the studies. Prevalence of myopia among school-age children in the EMR was high, particularly among older children, and it was more common among females. Early intervention to slow myopia progression is essential in the EMR to protect children from irreversible vision loss.

Epidemiological Assessment of Factors Associated with Myopia in Medical Students

Relevance. Myopia in students can lead to various problems with vision and affect quality of life and academic achievement. Aim. To analyze factors associated with the presence of myopia among medical students to develop effective methods of prevention of this disease. Materials and methods. A non-anonymous questionnaire was conducted on myopia among medical students of the first to sixth year. The questionnaire was developed based on the analysis of published data and included the demographic information, questions concerning the medical history, family history and lifestyle. The questionnaire data were supplemented with information from recording medical forms No. 025 «Medical records of patients receiving outpatient care». The data of 323 medical students were analyzed. Descriptive and logistic regression analyses were performed. Adjusted odds ratio (aOR) and 95% confidence intervals (95% CI) for each factor were calculated. Results. The median age of students was 21 years [Q1–Q3 = 19–23], min age = 17 years, max = 31 years. According to the ophthalmologist's examination, 68.7% of students had myopia (95% CI 63.4–73.7). Healthy weight and underweight were associated with the presence of myopia compared to those who are overweight or obese: aOR 2.433 (95% CI 1.096–5.403, p = 0.029) and aOR 2.774 (95% CI 1.231–6.253, p = 0.014), respectively. The presence of 8-hour sleep is associated with a decrease in the chances of having myopia by 2,321 times (aOR 0.431; 95% CI 0.190–0.979; p = 0.044). A large number of steps per day was associated with the absence of myopia. Those who walk 10,000 steps or more per day are 7.46 times less likely to have myopia than those who walk less than 2,000 steps per day. Conclusion. We report a high prevalence of myopia in medical students. The findings suggest that health promotion, including adequate sleep and regular physical activity, can be an effective strategy to prevent the occurrence or progression of myopia and other eye complications.

A study on the distribution characteristics of peripheral retinal defocus in children and adolescents

Objective: To explore the distribution characteristics of peripheral retinal defocus in children and adolescents. Methods: This cross-sectional study included 500 individuals aged 3 to 18 years, who visited the People's Hospital of Lincang, the First Affiliated Hospital of Dali University and Dali Ophthalmology Hospital between January and December 2021. Data of the right eye of each participant was analyzed. There were 226 males (45.20%) and 274 females (54.80%), with an average age of (10.79±3.79) years. All participants underwent post-cycloplegic refraction, optical biometry, and intraocular pressure measurement to obtain spherical equivalent, average corneal curvature, axial length, and intraocular pressure. Multispectral refraction topography was performed to obtain topographic maps and values at various field angles and orientations of peripheral retinal defocus. Based on multispectral refraction topography, peripheral retinal defocus values were categorized as crater type, hemilateral upturn type, saddle type, and relatively flat type. The distribution of different refractive states was analyzed. Results: The spherical equivalent of the 500 participants was(-1.51±2.61) D, axial length was (24.10±1.28) mm, and average corneal curvature was (43.20±1.22) D. Among the 500 eyes, 382 exhibited hyperopic peripheral retinal defocus values, with 316 eyes (82.72%) being myopic. Myopic peripheral retinal defocus values were observed in 118 eyes, with 15 eyes (12.72%) being myopic. Among different types of peripheral retinal defocus values, 112 eyes (22.4%) exhibited a crater type, 153 eyes (30.6%) exhibited a hemilateral upturn type, 107 eyes (21.4%) exhibited a saddle type, and 128 eyes (25.6%) exhibited a flat type. The proportion of myopia was 82.14% (92 eyes), 69.28% (106 eyes), 60.75% (65 eyes), and 3.90% (5 eyes), respectively. The peripheral retinal defocus values at 15°, 30°, and 45° were (0.01±0.08) D, (0.06±0.21) D, and (0.20±0.37) D, respectively. The peripheral retinal defocus values at temporal, inferior, nasal, and superior locations were (0.58±0.69) D, (0.52±0.63) D, (0.21±0.64) D, and (-0.26±0.67) D, respectively. Notably, the superior primarily manifested as myopic, while the others were predominantly hyperopic. Conclusions: Approximately three-fourths of children and adolescents exhibit hyperopic peripheral retinal defocus values, with a higher prevalence of myopia in this subgroup. The hyperopia peripheral retinal defocus value increases with the distance from the retina to the macula. The peripheral retinal defocus values between superior and inferior, nasal and temporal locations are asymmetrical, with the temporal hyperopic peripheral retinal defocus value being most prominent and the superior myopic peripheral retinal defocus value being most evident.

Factors affecting prevalence of myopia among undergraduate medical students: A cross-sectional study

Myopia, often known as nearsightedness, is the most common cause of vision impairment and is becoming more and more common globally. Presently it is effecting more among professional students who are busy in studies and having screen time more than usual. The aim of present study is to evaluate the factors affecting prevalence of myopia among medical undergraduates.The present cross sectional study was conducted among 590 undergraduate medical students of Punjab Institute of Medical Sciences, Jalandhar, Punjab for a period of two months. The self-administered questionnaire was created and sent to students through google forms and whatsapp. Results were analyzed using SPSS version 25.0 keeping level of significance at p less than 0.05.Prevalence of myopia among undergraduate medical students was found to be 70.3%. Maximum students were in the age group of 21-25 years (62.7%), females (58.7%) were more in number as compared to males (41.3%). Total 42.2% of students have family history related to myopia out of which 77.1% had myopia. Association between sociodemographic, parental, lifestyle factors and prevalence of myopia was done; only parental history showed significant results with p value 0.003.The current study revealed that there is high prevalence of myopia among undergraduate medical students specially in females. Positive parental history has significant association with prevalence of myopia.

How Childhood Obesity May Be Harming Your Child’s Vision: A Systematic Review of High Myopia in Obese Children and Adolescents

Abstract&#x0D; Introduction &amp; Objectives : High myopia is a severe and progressive form of myopia that can result in blindness. The prevalenceof high myopia is rising globally, and obesity has been identified as a potential risk factor, particularly in children and adolescents. This review aims to evaluate complex interplay between obesity and myopia in the young population.&#x0D; Methods : A systematic literature review was conducted through PubMed, Embase, and Cochrane databases using relevant keywords. Abstract-only papers, case reports/series, and review studies were excluded, and only studies published in English between 2019 - 2023 were considered. The study selection process will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram.&#x0D; Results : This review analyzed four studies that involved 1.326.898 participants aged between 5 to 19 years. The majority of the studies found a significant association between obesity and high myopia (p&lt;0.05). One of the studies reported that individuals with a normal BMI have a 40% lower risk of developing high myopia compared to those who are obese. Additionally, one study found that even a slightly higher BMI value, which is not yet categorized as obesity, was significantly linked to high myopia (OR 1.19; p=0.009).&#x0D; Conclusion : Most of the studies showed a significant association between high myopia and higher BMI, especially in cases of obesity. However, to establish a deeper understanding of the potential link between high myopia and obesity, further studies are necessary to consolidate data from a larger population and investigate the underlying pathological pathway.

Investigation and analysis of the status of myopia and related behavior in children and adolescents in Northeast Sichuan.

In this study, we examined the current status of myopia among primary and secondary school children in northeastern Sichuan to analyze the factors connected to myopia and provide data support and a theoretical foundation for the prevention and control of myopia. Using a cross-sectional study and a comprehensive sampling survey, 34,138 students aged 5-19 years were screened for refraction in 22 primary and secondary schools in Langzhong, and 4000 behavioral questionnaires were delivered at random. After evaluation and rational problem-solving, a total of 3764 valid questionnaires were obtained. SPSS 23.0 statistical software was used for data analysis. The percentage of myopia among primary and secondary school students in Langzhong was 65.61%, with female students having a higher rate than male students ( P < 0.05); 52.81% of primary school students, 86.26% of secondary school students, and 88.17% of high school students had myopia. The incidence of myopia detection increased with school age ( P < 0.001), indicating a correlation between age and myopia prevalence. The prevalence of myopia was mainly low (40.53%) and moderate myopia (19.89%). The prevalence of high myopia (5.19%) was relatively high. The prevalence of myopia among female students (5.54%) was greater than that in male students ( P < 0.05) and increased with age ( P < 0.001). The proportion of students who wore eyeglasses was 24.36%, with a larger proportion of female students (25.93%) than male students (22.61%) ( P < 0.001). In addition, the rate of eyeglass use increased with school age ( P < 0.001). A logistic regression analysis revealed that higher grade point averages, female gender, and long-term usage of electronic items were risk factors for myopia. The results of the questionnaire survey revealed that students in this region were under immense pressure to perform well academically, spent a lot of time engaged in near-work activities, and had a low rate of myopia awareness; 24.43% of the students had not had a vision examination in the previous year, indicating that parents did not pay sufficient attention to eye health. The incidence of myopia among children and teenagers is high in Northeast Sichuan, and the outlook for addressing the problem is bleak. Therefore, it is critical to improve vision monitoring and eye health education.

Myopia, what causes it and can it be avoided?

Myopia (short‐sightedness or near‐sightedness) is a condition of refraction where vision to distant is impaired. Axial elongation of the eye is the main anatomical cause of myopia.The prevalence of myopia has increased alarmingly fast globally. The estimation of WHO report was that in 2020 27% of world's population would be myopic, and if there will be no changes in the trend then by 2050 there would be 2.56 billion myopic people worldwide. Highest prevalence of myopia has been reported in many South and East Asian countries, where about 80% of the school leavers are myopic. Parental myopia increases the risks of myopia in their children, two myopic parents more than one. Genetic studies have been able to explain only small part of myopia, nor have been able to explain the differences in the prevalence between populations. Myopia relates to higher education, near work and higher occupational status and is mare rare in urban environment and in occupations where people work outdoors. In children myopia usually develop after they had begun attending school and is associated with more time spent on reading and near work and less time on outdoor activities.The major public health concerns connected with myopia are related to its complications. Myopia has become one of the main causes of vision loss due to complications, such as retinal detachment, macular degeneration and haemorrhage, choroidal neovascularization, and open angle glaucoma. The higher myopia is the higher is the risk of these complications. In countries where myopia is common, it is already a significant cause of low vision and blindness.In a Finnish study prevalence of myopia in 7‐ and 11‐year‐olds, was 0.5% and 3.3%, respectively, if daily near work did not exceed 1 h. Multiple regression model adjusted by sex, parental myopia and time spent outdoors, showed that 1 h increase in near work increased the risk of myopia 47% (95% CI 1.099–1.984, P = 0.010) and 35% (CI 1.170–1.548, P &lt; 0.001), in 7‐ and 11‐year‐olds, respectively. Each hour spent outdoors adjusted by sex, parental myopia and time spent outdoors decreased their same risk by 24% (95% CI 0.533–1050, P = 0.096 and 0.648–0.000, P = 0.001, respectively). Higher prevalence of myopia in girls could mainly be explained by their more time spent in near work and less time outdoors.Plenty of long‐term near viewing, and short viewing distance, combined with low amount of time outdoors are risk factors for myopia. Avoiding these factors is more important the younger the child is. It is recommended that the daily time spent outdoors in children should be at least equal to near work time. Early school starting age, increases the risk of myopia and high myopia, and consequently risk for myopia related complications. Great educational stress in young children should be avoided.

Awareness of high and pathological myopia among myopic patients in China: A cross‐sectional multicenter survey

AbstractThis study aimed to investigate the awareness of high and pathological myopia among patients with high myopia. A cross‐sectional multicenter survey involving both physicians and patients was conducted between February and April 2021. The outpatient education status, doctors' expectations toward patient education, patients' awareness of high/pathological myopia, and their access to relevant knowledge were inquired, and the proportions of patients with myopia, including high and pathological myopia, were assessed. In total, the survey involved 6975 physicians and patients with myopia from 161 medical institutions in China. The prevalence of high myopia among patients was 11.3%, with 22.59% having pathological myopia. Among those with pathological myopia, 22.45% experienced high myopia complications. Approximately 48.7% of the physicians believed that patients had only a vague idea about high/pathological myopia, with certain misconceptions. Additionally, most outpatients (61.4%) had no access to specialized staff for patient education. Patients' preferences and requirements for online ophthalmology information varied based on family background, medical history, and cognition toward myopia. This study demonstrated that the awareness level among patients with myopia regarding high and pathological myopia is currently insufficient. Therefore, it is important to enhance education efforts to reduce the incidence of adverse outcomes.

Trends in Myopia and High Myopia from 1966 to 2019 in Olmsted County, Minnesota

PurposeTo investigate the prevalence of myopia and high myopia in Olmsted County, Minnesota from 1966-2019. DesignRetrospective cross-sectional, trend study using a random population-based sample in Olmsted County, Minnesota from 1966-2019. MethodsManifest refractions or lens prescription were converted to spherical equivalent (SE) to estimate prevalence of adult myopia and high myopia. Age, sex, race, and visual acuity were recorded. Subjects with SE ≤-0.5 diopters (D) were considered myopic; ≤-6.0 D were considered high myopia. Exclusion criteria included visually significant cataract, pseudophakia, prior refractive surgery, or age <18 years-old. ResultsAmong 81,706 sampled subjects, myopia prevalence increased from 33.9% (95% CI 31.1-36.8) in 1960s to 57.1% (95% CI, 56.6-57.6) in 2010s (p<0.001). High myopia prevalence increased from 2.8% (95% CI, 1.95-3.98) in 1960s to 8.3% (95% CI, 8.08-8.62) in 2010s (p<0.001). Both males (32.0%-55.1%, p<.001) and females (40.6%-58.5%, p<.001) experienced increasing myopia prevalence from 1960s-2010s while males (2.6%-7.4%, p<.001) and females (3.4%-9.1%, p<.001) also had higher high myopia prevalence rates from 1960s through 2010s. Increasing myopia and high myopia prevalence was detected by decade in nearly all age groups (excluding 18-24-year-old high myopia subjects). White and Asian subjects had the highest myopia prevalence while Black subjects had the lowest. From the 2000s-2010s, White (53.3%-57.0%, p<0.001) and Black (41.0%-47.0%, p=0.001) subjects had significant increases in myopia prevalence. Mean SE decreased from the 1960s (-0.42 D; 95% CI -0.59-+2.49) to 2010s (-1.85 D; 95% CI, -1.88-+2.96) (p<0.001). ConclusionsFrom 1966-2019 in Olmsted County, Minnesota, there was a 68% and 199% increase in myopia and high myopia prevalence, respectively.

Time trends in myopia and high myopia prevalence in young university adults in China.

To investigate time trends in myopia and high myopia prevalence over 6y among young university adults in China. This is a 6-year series cross-sectional study from 2016 to 2021. Totally 4910 freshmen were enrolled and completed a questionnaire concerning age, gender, and disease history. Students with eye diseases were excluded after a detailed eye examination. The refractive status was measured by non-cycloplegic objective refraction and ocular parameters were measured by Lenstar 900. The examination followed the same protocol each year. Trends over time in myopia and high myopia prevalence, as well as ocular biometry parameters, were analyzed. From 2016 to 2021, the axial length (AL) and corneal radius (CR) increased significantly (P=0.002 for AL; P=0.04 for CR). However, the spherical equivalent (SE) and the ratio of axial length to the corneal radius (AL/CR) did not change significantly (P=0.59 for SE; P=0.24 for AL/CR). The frequency of AL ≥26.0 mm increased from 26.6% in 2016 to 29.3% in 2021 (P=0.05 for trend). The prevalence of myopia and high myopia did not change significantly in our study (P≥0.18). Compared to a similar cross-sectional study conducted 10 years ago, the prevalence of myopia decreased significantly (94.9% vs 91.8%, P<0.001). Whereas the prevalence of high myopia increased largely (18.12% vs 27.6%, P<0.001). The prevalence of high myopia increases in young university adults during 10y period. Myopia control should begin earlier in childhood. However, these interventions are still needed for high myopia even in young adulthood.

Association between Global Myopia Prevalence and International Levels of Education.

The Global Myopia Prevalence and International Levels of Education (MILE) study models national trends in educational performance with myopia prevalence in children; it examines the association of near work with myopia in the form of an ecologic analysis, and also discusses how this may relate to educational frameworks. To investigate the relationship between myopia prevalence and national educational performance. The prevalence of myopia in the 15-to-19-year age group in 35 regions was obtained from a meta-analysis by Holden et al. (2016) and matched with educational performance quantified by the Organisation for Economic Cooperation and Development (OECD) Program in Secondary Assessment (PISA) testing from 2000 to 2018. A generalized estimating equation (GEE) was used to describe the relationship between PISA scores and myopia prevalence. Clustering effects of country and chronological year were accounted for in the analysis. Linear and non-linear terms of PISA scores using line of best fit were further explored. There is a significant positive relationship between OECD PISA educational performance and myopia prevalence in teenagers with higher PISA scores correlating with higher myopia prevalence, even after accounting for chronological year (GEE model P = .001, .008, .005 for math, science and reading respectively). Scatterplots with cubic and logistic fits indicated that PISA math showed the strongest relationship with myopia prevalence (r 2 = 0.64) followed by science (r 2 = 0.41) and reading (r 2 = 0.31). These results strongly suggest that educational achievement at a national level is associated with higher myopia prevalence. PISA scores are a significant driver of many countries' education policies, and countries that have a balance between high PISA scores and lower myopia prevalence may be good models of educational policies to address the myopia public health issue.