Insights into Myopia: Unveiling the Vision Trends of Tomorrow’s Generation

by | May 9, 2024 | Pending

Myopia onset and progression during childhood and adolescence can have long-term implications for eye health in adulthood. High myopia is a known risk factor for sight-threatening complications such as retinal detachment, glaucoma, and myopic maculopathy. High myopia more readily leads to vision loss and impaired quality of life later in life. Early detection and management of myopia in childhood can help mitigate these long-term health risks and preserve vision into adulthood. Myopia has reached epidemic proportions in many parts of the world, with significant implications for public health. By identifying and understanding the prevalence and progression of myopia, patient protocols and public health initiatives can be developed to address this growing concern and prevent associated complications. Monitoring the prevalence and trends of refractive errors in children and adolescents is essential for promoting optimal eye health, improving educational outcomes, reducing healthcare costs, and mitigating the long-term impact of vision impairment on individuals and society as a whole. Understanding the typical path of a refractive error in juveniles informs ECPs of expected norms for their critical role in the battle against myopia.

METHODS

To recognize the degree of myopia during phases of childhood as seen in a typical eyecare practice, we reviewed a sample within the GPN database that consisted of over 500,000 patient records to review the prevalence of refractive error in children under age 20, who were cared for at more than 1,900 eyecare practices spread across the US during 2023. Using the average spherical equivalent of both eyes for each child, we categorized their refractive error into groups: emmetropia, hyperopia, and myopia by degree:  low (up to -3D), moderate (between -3D and -6D) and high (more minus, than -6D). The children were further grouped by age into 5-year bins: under 5; 5 to 9; 10-14 and 15 to 19.

RESULTS

In examining the overall distribution of children’s refractive error across all age groups in this sample, we see that myopia accounts for about 57% of the refractive errors in this sample; with 43.3% low myopia, 11.4% moderate and 2.2% high.  Non-myopic children are in the minority at 43% of the sample: further broken out as 31.5% Hyperopic and 11.6% Emmetropic. 

Tracking by age, among children under the age of five, we find 23.8% with myopia: 19.8% low, 2.8% moderate and 1.2% high myopia. Myopia rises to 39.3% among children aged 5 to 9 years, with 34.2% in the low myopia group, 4.3% moderate and 0.8% high. The 59.1% of the 10-14 year olds seen in these practices are myopic: 45.2% mildly, 11.9% moderately and 2% highly myopic.  And, in the oldest child age group, 15-19 years olds, myopia is found in 71.1% of the children visiting: with breakout as: 50.5% low, 16.9% moderate and 3.7% highly myopic. 

Among children under the age of five, hyperopia is the most prevalent refractive error, affecting 57.9% of this demographic. Similarly, hyperopia, at 49.9% remains predominant in 5 to 9-year-olds. However, by the time children enter the 10 to 14-year-old group, the predominant refractive error shifts to myopia, with 59.1% exhibiting this condition. Among adolescents aged 15 to 19 years myopia is rampant, affecting 71.1% of the children, with 3.7% exhibiting high myopia. 

DISCUSSION

High myopia shows a progressive increase from 1.2% in children under five to 3.7% in those aged 15-19. These results are derived from visits to our sample of eyecare practices, and not a direct reflection of the general population which includes people who do not seek eyecare or seek providers not represented in this sample. 

This data review highlights the pervasive nature of myopia among children and adolescents, with a clear trend of increasing prevalence and severity with age. Comparing a given patient’s age and stage of refractive error to these findings allows you to assess the risk of myopia and its progression and to guide treatment options. The age group selected for this study include children and adolescents, however a recent article points out that the risk of myopia onset or progression of existing myopia does not necessarily cease with end of adolescence. 

These findings underscore the importance of early intervention and implementing proactive measures, such as myopia control with contact lenses, atropine eyedrops, special spectacle lenses, as well as promoting outdoor activities and reducing screen time, to mitigate the progression of myopia and safeguard the visual health of the younger generation.

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By Ron Krefman, OD

Finding solutions in data science.

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