Changes in Refraction Over 10 Years in an Adult Population: The Beaver Dam Eye Study

  • The purpose of this study is to quantify the 10-year change in refraction in persons more than 40 years of age.

  • All people 43 to 84 years of age and living in Beaver Dam, Wisconsin, in 1988 were invited for a baseline examination (1988-1990), a 5-year follow-up examination (1993-1995), and a 10-year follow-up examination (1998-2000).

  • After adjustment for the severity of nuclear sclerosis and other factors, the 10-year change in refraction was +0.48, +0.03, and -0.19 D for persons 43 to 59, 60 to 69 and 70+ years of age at the baseline examination, respectively.

  • Severity of nuclear sclerosis was also strongly related to amount of change.

  • Those with mild nuclear sclerosis at baseline had a change of +0.35 D, whereas those with severe nuclear sclerosis had a change of -0.53 D. The amount of change was also related to diabetes and weakly related to baseline refractive error, but was unrelated to gender and education.

  • In addition to the longitudinal changes observed, there was a birth cohort effect. In comparing people of the same age across examinations, those born in more recent years had more myopia than those born in earlier years.

  • Significant changes in spherical equivalent in adults occur over a 10-year period. Younger people became more hyperopic, whereas older people became more myopic. These data provide evidence of a longitudinal change in refraction in adults, which may explain the refractive patterns observed in cross-sectional studies.

Publication date

April 16, 2019


Investigative Ophthalmology & Visual Science, Arvo Journal

Sponsor Institution

National Institutes of Health


Lee KE, Klein BE, Klein R, Wong TY.
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