Study shows spike in myopia prevalence from 1971 to 2004

Arch Ophthalmol. 2009;127(12):1632-1639.

Issue: March 10, 2010

The prevalence of myopia in the United States increased appreciably between 1971 and 2004, according to a study.

Study data suggested significant economic and health policy implications, the study authors said.

"Although myopia can be treated relatively easily with corrective lenses, it engenders substantial expenditures on a population basis owing to its high prevalence," they said. "If 25% of those aged 12 to 54 years had myopia, the associated annual cost would be more than $2 billion; an increase in prevalence to 37% would increase the cost to more than $3 billion."

The study included 4,436 patients participating in the National Health and Nutrition Examination Survey in 1971 to 1972 and 8,339 patients participating in the same survey from 1999 to 2004. The survey examination is conducted by the Centers for Disease Control and Prevention.

In the survey taking place from 1971 to 1972, examination involved a pinhole test to estimate corrected visual acuity in patients with presenting visual acuity worse than 20/20. Detailed retinoscopy was performed in eyes with presenting visual acuity of 20/50 or worse.

In the survey from 1999 to 2004, most participants underwent refraction. However, right eyes were classified as myopic or nonmyopic according to methods similar to those used earlier. Autorefraction was used instead of retinoscopy to measure objective refraction. Lensometry was not performed on contact lens wearers.

Study data showed that the overall prevalence of myopia among participants aged 12 to 54 years was 25% in 1971 to 1972 and 41.6% in 1999 to 2004. The difference was statistically significant (P < .001).

The prevalence of myopia among African American participants was 13% in 1971 to 1972 and 33.5% in 1999 to 2004. The prevalence among white participants rose from 26.3% to 43%. Both differences were statistically significant ( P < .001).

Other studies have attributed rising myopia among younger populations to burgeoning environmental factors, the authors said.

In the above referenced article from Archives of Ophthalmology, Vitale et al report that the prevalence of myopia was 66.4% higher in the more recent group than in the 1971 to 1972 group. In particular, it was found that black participants showed greater prevalence than whites in the 1999 group than in the 1971 group, as in surveys it was evident that more educational opportunities were available to all in the more recent group than in the ‘70s. The study also confirmed previous reviews that not only increasing levels of education but that a genetic susceptibility are responsible for increasing myopia prevalence. The authors make the point that the costs of the higher prevalence of myopia to the population must be clear to “health planners and policy makers” as we move into the future. This topic will certainly come up in future health care reform discussions in years to come.

– Robert S. Gold, MD
OSN Pediatrics/Strabismus Section Editor