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Updated: Nov 30, 2025
Binocular Dynamic Visual Acuity in Eyeglass-Corrected Myopic Patients
Published on: March 29, 2022
Racial and Ethnic Differences in Myopia Progression in a Large, Diverse Cohort of Pediatric Patients
Tiffany Q Luong1, Yu-Hsiang Shu1, Bobeck S Modjtahedi2
1Southern California Permanente Medical Group, Pasadena, California, United States.
Insights
Myopia progression varies by race and age in children. East/Southeast Asian children show faster myopia progression, particularly when diagnosed younger, compared to white children.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Genetics and Epidemiology of Eye Diseases
Background:
- Myopia, or nearsightedness, is a growing public health concern globally.
- Understanding ethnic and age-related differences in myopia progression is crucial for early intervention.
Purpose of the Study:
- To investigate and characterize variations in myopia progression among children based on race/ethnicity and age.
- To identify specific demographic groups at higher risk for rapid myopia development.
Main Methods:
- Retrospective cohort study of 11,595 children aged 4-11 years with myopia (refraction -1 to -6 D).
- Longitudinal analysis of spherical equivalent changes using linear mixed-effects modeling.
- Adjustments for confounders including BMI, screen time, and physical activity.
Main Results:
- Children of East/Southeast Asian descent exhibited significantly faster myopia progression over time (P < 0.001).
- Younger East/Southeast Asian patients (6 to <8 years) showed progression rates comparable to white patients in the same age group.
- These younger East/Southeast Asian patients progressed significantly faster than white patients in other age brackets.
Conclusions:
- Significant differences in myopia progression exist between East/Southeast Asian and white children.
- Age is a critical factor modulating myopia progression rates in different racial/ethnic groups.
Purpose:
The purpose of this study was to characterize the differences in myopic progression in children by race/ethnicity and age.
Methods:
Patients enrolled in Kaiser Permanente Southern California between 2011 and 2016 and between the ages of 4 and 11 years old with a documented refraction between -6 and -1 diopters (Ds) were included in this retrospective cohort study. Patients with a history of amblyopia, strabismus, retinopathy of prematurity, or prior ocular surgery were excluded from analyses. Patients' race/ethnicity and language information were used to create the following groups for analysis: white, Black, Hispanic, South Asian, East/Southeast Asian, Other Asian, and other/unknown. A growth curve analysis using linear mixed-effects modeling was used to trace longitudinal progression of spherical equivalents over time, modeled by race/ethnicity. Analyses adjusted for potential confounders, including body mass index (BMI), screen time, and physical activity.
Results:
There were 11,595 patients who met the inclusion criteria. Patients were 53% girls, 55% Latino, 15% white, 9% black, 9% East/Southeast Asian, and 2% South Asian. Mean age (standard deviation [SD]) at the time of initial refraction was 8.9 years (1.6 years). Patients had an average (SD) of 3.4 (1.5) refractions, including the baseline measurement, during the study period. A three-way interaction model that assessed the effects of age at baseline, time since baseline, and race/ethnicity found that children of East/Southeast Asian descent showed significantly faster myopia progression across time (P < 0.001). East/Southeast Asian patients who presented with myopia between 6 to < 8 years progressed similarly to white patients in the same age group and significantly faster compared with white patients in other age groups.
Conclusions:
Myopia progression differed significantly between East/Southeast Asian and white patients depending on the patients' age.
