A Review on the Epidemiology of Myopia in School Children Worldwide
Due 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.
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.
Low 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.