Increasing Prevalence of Myopia in Europe and the Impact of Education

Abstract

PurposeTo investigate whether myopia is becoming more common across Europe and explore whether increasing education levels, an important environmental risk factor for myopia, might explain any temporal trend.DesignMeta-analysis of population-based, cross-sectional studies from the European Eye Epidemiology (E3) Consortium.ParticipantsThe E3 Consortium is a collaborative network of epidemiological studies of common eye diseases in adults across Europe. Refractive data were available for 61 946 participants from 15 population-based studies performed between 1990 and 2013; participants had a range of median ages from 44 to 78 years.MethodsNoncycloplegic refraction, year of birth, and highest educational level achieved were obtained for all participants. Myopia was defined as a mean spherical equivalent ≤−0.75 diopters. A random-effects meta-analysis of age-specific myopia prevalence was performed, with sequential analyses stratified by year of birth and highest level of educational attainment.Main Outcome MeasuresVariation in age-specific myopia prevalence for differing years of birth and educational level.ResultsThere was a significant cohort effect for increasing myopia prevalence across more recent birth decades; age-standardized myopia prevalence increased from 17.8% (95% confidence interval [CI], 17.6–18.1) to 23.5% (95% CI, 23.2–23.7) in those born between 1910 and 1939 compared with 1940 and 1979 (P = 0.03). Education was significantly associated with myopia; for those completing primary, secondary, and higher education, the age-standardized prevalences were 25.4% (CI, 25.0–25.8), 29.1% (CI, 28.8–29.5), and 36.6% (CI, 36.1–37.2), respectively. Although more recent birth cohorts were more educated, this did not fully explain the cohort effect. Compared with the reference risk of participants born in the 1920s with only primary education, higher education or being born in the 1960s doubled the myopia prevalence ratio–2.43 (CI, 1.26–4.17) and 2.62 (CI, 1.31–5.00), respectively—whereas individuals born in the 1960s and completing higher education had approximately 4 times the reference risk: a prevalence ratio of 3.76 (CI, 2.21–6.57).ConclusionsMyopia is becoming more common in Europe; although education levels have increased and are associated with myopia, higher education seems to be an additive rather than explanatory factor. Increasing levels of myopia carry significant clinical and economic implications, with more people at risk of the sight-threatening complications associated with high myopia.

Myopia and Cognitive Performance: Results From the Gutenberg Health Study

“…This is in line with a recently published meta-analysis of population-based, cross-sectional studies from the European Eye Epidemiology (E3) Consortium which showed that the increase in the level of education in younger population did not fully explain the cohort effect of increasing myopia. 32 It is noteworthy with regards to our study that cognitive decline in older people is a different issue compared to the cognitive trajectory in a population based sample and the observation merits further investigation. Regarding the paper by Williams and colleagues 32 one has to keep in mind that the conclusion depended on the assumption that the demands of primary education did not change with age.…”

“…32 It is noteworthy with regards to our study that cognitive decline in older people is a different issue compared to the cognitive trajectory in a population based sample and the observation merits further investigation. Regarding the paper by Williams and colleagues 32 one has to keep in mind that the conclusion depended on the assumption that the demands of primary education did not change with age. In the oldest participants, the task of primary schools was to provide students with minimal numeracy and literacy, but in the post-WW2 period, the task had become to prepare children to go on to complete secondary and even postsecondary education, demanding higher standards.…”

Visual Acuity Stability of Ortho-K Treatment in a Child with Low Myopia: A Case Study

“…Shadows are formed at the anterior of the retina so it cannot see distant object clearly. This is due to axial elongation in myopia patient 1 . Increased prevalence of myopia in the world recently, especially in Southeast 1,2 and East Asia (80-90%) 3 is a serious health problem mainly for patients with high myopia 4 .…”

“…Myopia could occur as a result of heredity, ethnicity and environment, such as reading habit, often doing close activities 5,6 . Complication of high myopia is macula degeneration, glaucoma, cataract, strabismus and blindness 1 . This condition can decrease the quality of life in children and adult 4 .…”

Vitamin D in Dry Eye and Myopia

“…Studies have indicated that the prevalence of myopia is increasing in east and SouthEast Asian countries such as China, Hong Kong, Singapore, and Taiwan (Morgan & Rose, 2005), as well as Western communities such as the United States (Vitale et al, 2009), Australia (Morgan et al, 2012), and Europe (Williams et al, 2015). A potential consequence of myopia is reduced vision, and it is estimated that a quarter of the cases of reduced vision in people living in Western countries is due to myopia.…”