The prevalence and costs of optical correction for childhood myopia in Scotland

General Ophthalmic Services in Scotland (GOS(S)3) vouchers provide children with National Health Service (NHS)-funded optical correction. This study investigated the financial impact of myopia by reporting current spending on GOS(S)3 vouchers and indicative prevalence of childhood myopia in Scotland.

Data on the number and monetary value of GOS(S)3 vouchers issued for children aged 6-15 years in 2021/22 were obtained from Public Health Scotland. Data were categorised by age, refractive error and voucher value. Refractive error was defined as emmetropia (spherical equivalent refraction (SER) > -0.50D and < +2.00D), hyperopia (SER ≥ + 2.00D) and myopia (SER ≤ -0.50D). Total spending on GOS(S)3 vouchers and spending on additional GOS(S)3 voucher claims (due to spectacle prescription changes within 1 year) were reported. The proportions of additional GOS(S)3 vouchers for myopia and non-myopic refractive errors (hyperopia and emmetropia combined) were compared with a two-proportion z-test. Indicative prevalence was estimated by dividing the number of GOS(S)3 vouchers (excluding additional vouchers) by the number of children in the population, using data from the National Records of Scotland.

Total annual spending on GOS(S)3 vouchers for the correction of emmetropia, hyperopia and myopia was £1.44 million, £1.43 million and £1.91 million, respectively. A greater proportion of GOS(S)3 vouchers was attributed to additional claims for myopia (6.31%) compared to non-myopic refractive errors (4.10%) (p < 0.001). The prevalence of myopia as indicated by voucher claims ranged from 2.21% in children aged 6-7 years to 11.95% in 15 year olds. The proportion of children aged 6-15 years requiring spectacles for high myopia (spherical component < -6.00D) was approximately 0.26%, accounting for 3.62% of myopic children.

Total spending on GOS(S)3 vouchers for the correction of myopia is lower than the combined spending on GOS(S)3 vouchers for emmetropia and hyperopia. However, children with myopia received more additional GOS(S)3 vouchers than other refractive groups, suggesting these children experienced more short-term changes to their spectacle prescription.