Visual Impairment and Blindness in Indian Myopes Aged 10-40 Years: A Multicenter Hospital-Based Study

The objective of this study was to investigate the proportion of individuals with visual impairment (VI) and blindness due to myopia based on age, gender, magnitude of myopia, and myopia-related retinal changes using a large-scale database from two large tertiary-level eye care networks in India.

Retrospective study.

A total of 46 162 individuals with myopia (≤ -0.50) aged >10 to <40 years were included.

The electronic medical record data of myopic individuals who visited two tertiary eye care centers in India between January 2018 and December 2018 were analyzed. They underwent a comprehensive ophthalmic examination, which included measuring best-corrected visual acuity (BCVA) by subjective refraction and evaluating the fundus using dilated indirect ophthalmoscopy. Visual impairment and blindness were defined using BCVA of the better-seeing eye according to the World Health Organization (WHO) criteria (VI: <20/40 to ≥20/400; blindness: <20/400). Additional analysis was performed based on the worse-seeing eye. An odds ratio was used to test the association of age, gender, and degree of myopia with VI.

Proportion of individuals with VI and blindness among Indian individuals with myopia, stratified by degree of myopia and the presence or absence of myopia-related retinal changes.

Based on WHO criteria using BCVA in the better-seeing eye, the proportion of VI and blindness among individuals with myopia was 1.03% (95% confidence interval [CI], 0.93-1.12) and 0.02% (95% CI, 0.00-0.03), respectively. When defined using the worse-seeing eye, the corresponding proportions were 3.53% for VI and 0.38% for blindness. The proportion of VI increased with the severity of myopia, rising from 0.14% in mild myopia to 11.96% in very high myopia, and was higher in the presence of myopia-related retinal lesions (0.41% vs. 7.62%).

In this large hospital-based cohort, VI was present in about 1% of young and middle-aged individuals (10 to 39.9 years) with myopia and in 4% of those with high myopia. The occurrence of VI was 15 times higher in individuals with myopia-related retinal lesions than in those without retinal changes.

The authors have no proprietary or commercial interest in any materials discussed in this article.