Epidemiology of Myopia
Myopia is a major health problem throughout the world due to its increasingly high prevalence in the past few decades. Myopia, in particular high myopia, is directly or indirectly associated with a number of ocular complications such as glaucoma and catar
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Epidemiology of Myopia Chen-Wei Pan, Seang-Mei Saw, and Tien-Yin Wong
Myopia is a significant global public health concern with a rapid increase in prevalence in recent decades worldwide [1–3]. It is estimated that globally 153 million people over 5 years of age are visually impaired as a result of uncorrected myopia and other refractive errors, and of these eight million are blind [4]. The economic costs of myopia to individuals and society have been estimated to be $250 million/year in the USA alone [5]. Myopia is an important and usually underestimated eye disease. Although impaired vision resulting from myopia can often be corrected with visual aids, such as glasses, contact lenses, or refractive surgery, uncorrected refractive error is still the major cause of visual impairment worldwide, accounting for at least 33 % of visual impairment [6]. Furthermore, myopia is more common than other eye diseases such as glaucoma, cataract, or diabetic retinopathy in East Asian populations. High myopia poses an enormous burden because of the higher risks of macular and retinal complications [7–10]. Myopia is a complex multifactorial trait driven by both genetic and environmental factors [2, 11–13]. Environmental exposures play a major role [1, 2]. This is supported by animal experiments which showed that manipulation of the
C.-W. Pan, MD, PhD Saw Swee Hock School of Public Health, National University of Singapore, 16 Medical Drive, MD 3, Singapore, 117597, Singapore e-mail: [email protected] S.-M. Saw, MPH, PhD • T.-Y. Wong, MD, PhD (*) Department of Ophthalmology, Saw Swee Hock School of Public Health, National University of Singapore, 16 Medical Drive, MD 3, Singapore 117597, Singapore Singapore Eye Research Institute, 11 Third Hospital Ave, #05-00, Singapore 168751, Singapore Department of Ophthalmology, National University of Singapore, Singapore, Singapore e-mail: [email protected]; [email protected]
environment can be achieved by making animals wear negative lenses, which would place the images of distant objects behind photoreceptors (hyperopic defocus), or most commonly by lens-induced myopia or form-deprivation myopia [14]. Macaque monkeys with surgically fused eyelids, i.e., form deprivation, experienced excessive axial length (AL) elongation and eventually develop myopia [15]. In addition, the environmental impact on myopia is also supported by the rapid increases in the prevalence of myopia over the past few decades that cannot be attributed to changing gene pools [1].
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East–West Patterns in the Prevalence of Myopia
Myopia prevalence has been reported to be high in middleaged to elderly Chinese adults in urban Asian cities. The prevalence of myopia of any amount (spherical equivalent [SE]
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