Relationship Between Lifestyle During School Years, Ocular Biomechanics and Refractive Status in Adult Myopes

To investigate the relationship between ocular biomechanical properties in adult myopes and lifestyle habits during school years, aiming to identify behavioral patterns that may influence ocular tissue behavior and refractive development.

This cross-sectional study included adult myopes. Biomechanical parameters were obtained using the Corvis ST^®. Variables analyzed included the first- and second-generation parameters. Demographic and lifestyle data were collected through a validated retrospective questionnaire (google form) including outdoor activity levels, sleep posture, digital device usage, educational attainment, family history of myopia, allergic conditions and eye rubbing. Statistical comparisons were made between subgroups based on these factors.

The study included 390 myopic eyes, with a mean spherical equivalent (SE) of -5,09±3,8D from 195 individuals with a mean age of 32,72±5,4 years-old. Lower ocular rigidity and a higher myopic spherical equivalent was found in eyes from individuals with personal history of allergies (p=0,00; p=0,03), family history of myopia (p=0,00; p=0,00), predominance of indoor extracurricular activities during school years (p=0,07; p=0,03) and exposure to touchscreen devices under 15 years-old (p=0,00; p=0,05). Eyes submitted to rubbing habits (p=0,05) or from individuals with higher academic degree (p=0,01) showed higher spherical equivalent. Eyes from individuals with predominantly ventral sleeping habits showed lower CBI (p=0,06) and TBI (p=0,01). A multivariable regression found a later age of digital device initiation (β = 0.0446, p = 0.014) to be predictor of higher Stress Strain Index and family history of myopia exhibited negative association (β = -0.044, p = 0.014).

This study highlights the potential pivotal role of ocular tissue and its biomechanical behavior in translating demographic factors and lifestyle habits during the period of ocular growth into the refractive status later in adulthood. These findings pave the way for the use of ocular biomechanical analysis as one of the predictors of myopia in the future.