A recent meta-analysis published in the British Journal of Ophthalmology reveals a troubling increase in childhood myopia, now affecting 35.8% of children globally. The study, which examined 276 research papers, projects that 740 million children could be affected by 2050. The analysis spotlights gender and regional disparities, citing those in East Asian countries as exhibiting the highest prevalence rates, with Japan ranking the highest at 86%, and girls being disproportionately affected compared to boys. Urgent public health measures are needed. Photo: Getty Images. Click image to enlarge.

Over the past 30 years, the prevalence of myopia in children and adolescents has increased from 24.3% to 35.8%. Recently published studies now include time periods encompassing the COVID-19 pandemic, which suggest a potential association between it and the accelerated vision deterioration in younger populations, specifically. In an effort to gauge the current impact and trajectory of myopia, a comprehensive analysis published in British Journal of Ophthalmology analyzed 276 studies. Their findings project an alarming 39.8% rate of global myopia by 2050, particularly affecting girls, low- and middle-income nations and East Asian regions.

The current estimated global prevalence of myopia in children has increased substantially during the preceding three decades: 2001-2010 (25.3%) vs. 2011-2019 (29.7%) vs. 2020-2023 (35.8%). This most recent surge may be attributed partly to the COVID-19 pandemic and the transition to more remote-based learning, suggested the authors. It was also observed that developing or underdeveloped countries exhibited a significantly higher prevalence estimate of myopia (31.9%) compared with developed countries (23.8%). Disparities were also stark across continents, with Asia exhibiting the highest estimate of 35.2%, and Latin America and the Caribbean demonstrating the lowest at 3.8%. Additionally, the analysis delved into country-specific myopia levels, identifying Japan with the highest estimated rate of myopia (86.0%), followed by the Republic of Korea (73.9%). Paraguay showed the lowest myopia estimate at 0.84%.

This research revealed notable disparities among those affected by myopia. In particular, girls have a marginally higher estimated prevalence (33.6%) compared to boys (30.5%), with rates reaching 45.5% among high-school aged girls and 48.8% among adolescent girls.

Myopia prevalence is only expected to escalate in the coming decades, according to research that projects approximately 740 million children and adolescents being affected by the year 2050.

This meta-analysis comprises 5,410,945 participants spanning 50 and six continents, obtained from multiple databases, including some sources as recent as through June 2023. Previous meta-analyses only included information up to 2015, according to the study authors. “It is important to consider other factors that may have influenced myopia prevalence but have not been accounted for in their study, such as the impact of the COVID-19

pandemic,” they wrote. “Emerging evidence suggests a potential association between the pandemic and accelerated vision deterioration among young adults.”

The paper for BJO discusses the regional disparities, particularly in Asian countries, and suggests a possible correlation between the duration of education and the occurrence of myopia. Early implementation of formal education in certain East Asian countries could potentially contribute, they wrote, adding that children as young as three years old in Singapore and as young as two years old in Hong Kong actively engage in supplementary educational programs before beginning formal schooling. “Conversely, African populations exhibit a lower prevalence of myopia, likely attributed to lower literacy rates and delayed initiation of formal education, typically occurring between the ages of six to eight years for most children,” they wrote.

Sex-based differences in myopia prevalence appear to manifest around age nine, according to the authors. They cite the influences of educational pursuits and activities involving close proximity in girls, compared with boys. “Additionally, girls in elementary and middle school tend to have shorter durations of outdoor activities compared with boys, resulting in longer periods of close-range activities with their eyes,” said the authors. “Consequently, these factors collectively contribute to a higher prevalence of myopia among girls in comparison to boys, and girls tend to experience the onset of myopia at an earlier age.”

The authors say evidence-based solutions are needed at both the individual and public health levels. “It is important for young individuals to develop the habit of regularly practicing eye-protective measures,” they concluded. “Students should also increase the amount of time spent on physical activity and decrease the time spent on non-active activities such as watching television and videos, playing computer games, and surfing the internet.” Educational policies less reliant on formal homework would also help, the offered.