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Published on: September 16, 2025
Ocular biometry and determinants of refractive error in a founder population of European ancestry
Sarah M Hilkert1,2,3, Reut Parness-Yossifon1,2,4, Rebecca Mets-Halgrimson1,2
1a Feinberg School of Medicine , Northwestern University , Chicago , Illinois , USA.
Background:
The prevalence of myopia is increasing worldwide. Previous studies have found a positive association between myopia, education, and near activities, while others have noted a negative association with outdoor exposure. This study reports refractive error and biometry in a founder population of European ancestry, the Hutterites, and discusses risk factors contributing to myopia.
Methods:
Cross-sectional study, including complete eye exams with retinoscopy and biometry.
Results:
939 study participants, ages 6 to 89, were examined. Females were significantly more myopic than males (SE -0.87 ± 2.07 and -0.40 ± 1.49 in females and males, respectively, p < 0.0001). Males had significantly longer axial lengths. Females had steeper corneas. This is the first epidemiological report of refractive error among the Hutterites.
Discussion:
As a genetically isolated population with a communal lifestyle, the Hutterites present a unique opportunity to study risk factors for myopia. Hutterite females are more myopic than males, a finding which has only been reported in a few other populations. Hutterite children complete compulsory education through the 8th grade, after which women and men assume gender-specific occupational tasks. Men often work outside on the farm, while women engage in more domestic activities inside. These occupational differences likely contribute to the increased myopia comparing females to males, and their uniform lifestyle reduces the impact of potential confounding factors, such as education and income.
Conclusions:
The Hutterites are more myopic than most other North American and European populations. Greater time spent doing near work and less time spent outdoors likely explain the increased myopia comparing females to males.
