The epidemiology of myopia

Many people have reduced unaided vision because of myopia, a spherical error of refraction. The biological theory of myopia views myopia as the result of genetically determined characteristics of eye tissues, whereas the use-abuse theory views myopia as the result of habitual use of the eye at a near focal length, near-work. The use-abuse theory implies that myopia is preventable whereas the biological theory does not. Myopia varies over age, gender, race, ethnicity, level of education, social class and degree of urbanization. The explanation of the epidemiology of myopia in the use-abuse theory is that some types of people do more near-work than others. Using data from the Health Examination Survey of 12 to 17-year-olds conducted by the US Public Health Service from 1966--1970, this paper finds that the use-abuse theory can explain at least some of the variance of myopia and much of the socially patterned variance. This finding raises the possibility that at least some of the myopia extant in a population is preventable.