Increased prevalence of myopia in the United States between 1971-1972 and 1999-2004—A reappraisal and model

Abstract

Purpose : Prevalence of myopia in the United States population was estimated to increase from 25% to 42% over the thirty years between the 1971-1972 and 1999-2004 National Health and Nutrition Examination Survey (NHANES).1 However, there were unexplained anomalies in the data set whereby, for example, those aged 18-24 years in 1971-1972 had a myopia prevalence of 28% which increased to 45% among those aged 45-54 years in 1999-2004, suggesting a component of adult myopia onset . Here, we reappraise these data and propose a model to account for the thirty-year changes.

Methods : We modelled prevalence of myopia by age and time, allowing for both increased prevalence and adult myopia progression between surveys. By way of illustration, frame A of the figure assumes a starting prevalence of 25% among those aged 18 to 24 years in 1971-1972, with no increased prevalence or adult progression over time. In frame B, an increase of 15% prevalence between surveys is assumed but no adult progression. Frame C shows adult onset of 15% between surveys in the absence of change of prevalence across time. In frame D, both an overall increase of myopia prevalence of 15% and adult onset of 15% are modelled. A simple regression was performed on the data from NHANES to estimate the starting prevalence of the youngest age group in 1971-72, the rate of progression across time and adult progression. A similar process was performed using data for a threshold of –2 D, which models adult progression rather than onset.

Results : The myopia prevalence data are best explained by an increase of 13.0% in overall population prevalence and an increase of 17.1% due to adult-onset myopia (frame E). For a myopia criterion of –2D (not shown), an increase of 8.8% in overall population prevalence for this threshold is estimated with an increase of 13.7% due to adult myopic progression.

Conclusions : The differences between the NHANES data from 1971-1972 and 1999-2004 are best explained by, not only an increase in overall population myopia prevalence, but a substantial component of myopic adult onset and progression.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Prevalence of myopia. A. no increased prevalence over time or adult-onset myopia. B. an 15% increase in prevalence, but no or adult-onset myopia. C. no increased prevalence over time, 15% adult-onset myopia. D. both a 15% increase in myopia prevalence and 15% adult-onset myopia. E. NHANES myopia prevalence data and model.