Modelling changes in the prevalence of childhood myopia

To re-examine the changes with time in the underlying patterns of individual refraction at different ages, which have led to an increased prevalence of myopia in a population of Asian children.

Using published cross-sectional longitudinal data, the frequency distributions of spherical equivalent refractive error (SE) in yearly cohorts of 6- and 12-year-old Japanese children during the period 1984-1996 were modelled in terms of ex- and bi-Gaussian distributions.

Both models suggested that over the period of the study, little change occurred in the SE frequency distributions for 6-year-olds, with most children having SEs near emmetropia. In contrast, in each annual cohort of 12-year-olds, although the SE of some children remained near-emmetropic, a sub-set failed to maintain emmetropia. Most of this group became more myopic between 6 and 12 years of age. The proportion of children showing myopic progression increased over the period of study.

The observed increase in mean levels of myopia in older Japanese children in the late 20th century is due to a greater proportion of children failing to maintain emmetropisation between the ages of 6 and 12, rather than to myopic shifts in all children. Some children, with small SE changes between 6 and 12 years of age, would not have benefitted from any treatment intended to slow myopia progression.