Time trends on the prevalence of myopia in India - A prediction model for 2050

This study aimed to predict myopia prevalence in urban Indian children and to describe the generational effect of myopia in different age groups over the next three decades from the year 2020.

A systematic review of myopia prevalence in India was performed using the Preferred Reporting Items for the Systematic Reviews and Meta-analysis (PRISMA) guidelines and included eight studies with 28 600 participants, which were published in the period 1 January 1999 to 31 December 2019. The best fit for the prediction model was assessed with the baseline prevalence data plotted against different years and fitted with multiple mathematical regressions (linear, second-order polynomial, third order polynomial and exponential). Based on the quality of the fit assessed by the coefficient of determination (R² ) values, the sum of squared residuals and statistical significance, final predictions for myopia prevalence in the 5 to 15-year-old urban Indian children was estimated using the aptly suited linear regression model. To describe the generational effect on myopia prevalence over the next three decades, the prevalence of myopia in both children and adults, based on the available literature (1999 to 2020) was plotted against age, as the baseline.

The prevalence of myopia in 5 to 15-year-old urban children increased from 4.44% in 1999 to 21.15% in 2019. Our predictions, based on the slope of 0.8% every year (4.05% for every 5 years) indicate that the prevalence of myopia will increase to 31.89% in 2030, 40.01% in 2040 and 48.14% in 2050. Due to the generational effect (caused by the nature of the condition lasting a lifetime once developed), there will be an overall increase in myopia prevalence across all age groups of 10.53% in the next three decades (2020 to 2050).

The estimates of myopia prevalence across all age groups indicate the possible future epidemic of myopia in India within a few decades, similar to the situation in East Asian countries, unless active intervention to prevent myopia and changes in lifestyle are instigated to counteract myopia in India. Meticulously designed eye care services with focussed anti-myopia strategies are needed to control the rising myopia prevalence in India.