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A review on the epidemiology of myopia in school children worldwide

Authors
  • Grzybowski, Andrzej1, 2
  • Kanclerz, Piotr3
  • Tsubota, Kazuo4, 5
  • Lanca, Carla6
  • Saw, Seang-Mei6, 7, 8
  • 1 University of Warmia and Mazury, Olsztyn, Poland , Olsztyn (Poland)
  • 2 Institute for Research in Ophthalmology, Gorczyczewskiego 2/3, Poznan, 60-554, Poland , Poznan (Poland)
  • 3 Private Practice, Gdańsk, Poland , Gdańsk (Poland)
  • 4 Keio University School of Medicine, Tokyo, Japan , Tokyo (Japan)
  • 5 Tsubota Laboratory, Inc., Tokyo, Japan , Tokyo (Japan)
  • 6 Singapore Eye Research Institute, Singapore, Singapore , Singapore (Singapore)
  • 7 National University of Singapore, Singapore, Singapore , Singapore (Singapore)
  • 8 Duke-NUS Medical School, Singapore, Singapore , Singapore (Singapore)
Type
Published Article
Journal
BMC Ophthalmology
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Jan 14, 2020
Volume
20
Issue
1
Identifiers
DOI: 10.1186/s12886-019-1220-0
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundDue to high prevalence myopia has gained importance in epidemiological studies. Children with early onset are at particular risk of complications associated with myopia, as progression over time might result in high myopia and myopic macular degeneration. Both genetic and environmental factors play a role in the increasing prevalence of myopia. The aim of this study is to review the current literature on epidemiology and risk factors for myopia in school children (aged 6–19 years) around the world.Main bodyPubMed 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 2013 and Mar 2019 were included in the study. Studies were critically reviewed for study methodology and robustness of data. Eighty studies were included in this literature review.Myopia prevalence 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 (73%), and high rates in North America (42%). Low prevalence under 10% was described in African and South American children. In recent studies, risk factors for myopia in schoolchildren included low outdoor time and near work, dim light exposure, the use of LED lamps for homework, low sleeping hours, reading distance less than 25 cm and living in an urban environment.ConclusionLow levels of outdoor activity and near work are well-established risk factors for myopia; this review provides evidence on additional environmental risk factors. New epidemiological studies should be carried out on implementation of public health strategies to tackle and avoid myopia. As the myopia prevalence rates in non-cycloplegic studies are overestimated, we recommend considering only cycloplegic measurements.

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