Prevalence of myopia in Europe: a systematic review and meta-analysis of data from 14 countries

Although myopia prevalence increased in East Asian countries, the burden of myopia in Europe is less known. We performed a systematic review and meta-analysis to estimate the prevalence of myopia in Europe and at the country level.

We searched PubMed, Scopus and Web of Science to identify studies on myopia prevalence published until January 2024, regardless of language. We included European cross-sectional and cohort studies with defined sampling strategies and excluded clinical surveys, myopia registries, self-reported near-sightedness, and non-representative populations. Pooled prevalence was estimated using random-effects models. Heterogeneity was assessed using the Cochran's Q (χ² test) and the I² statistic. The study protocol was preregistered in PROSPERO (CRD42023471527).

We screened 2074 records and included 22 studies (from 14 European countries; n = 128,012) in the meta-analyses. The pooled prevalence of myopia was 23.5% (95% CI: 18.5-29.3; I² = 99.7%), ranging from 11.9% in Finland to 49.7% in Sweden. In cycloplegic studies, myopia prevalence was 18.9% (95% CI: 13.2-26.5%; I² = 99.7%) vs. 31.2% (95% CI: 24.9-38.3%; I² = 99.3%) in non-cycloplegic studies. Subgroup and meta-regression analyses exploring sources of heterogeneity showed a lower prevalence in children (6-11 years; 5.5%) compared with adolescents (12-17 years; 25.2%) and adults (18-39 years; 24.3%) in cycloplegic studies. No significant differences in prevalence were observed between sexes. Myopia prevalence increased significantly between 2000-2010 and 2011-2022 (p = 0.040), although age-specific trends remained stable.

Myopia prevalence in Europe is lower than in Asia, with a less pronounced increase that disappears after stratifying by cycloplegic refraction and age. These findings highlight the need for age-specific data and cycloplegic refraction in future studies to reduce heterogeneity. Uneven country representation may limit the generalisability of these results.

The present publication was funded by Fundação Ciência e Tecnologia, IP national support through UID/04923-Comprehensive Health Research Centre.