Myopia (nearsightedness) is a common eye condition reaching epidemic proportions in many countries around the world. The incidence of high myopia – a relatively severe level of nearsightedness – is also increasing at a rapid rate. This is of special concern because high myopia increases the risk of significant eye health complications, which can lead to blindness later in life. In East Asia, the incidence of high myopia is estimated to be 7 - 10% among 14- to 16-year-olds. The onset of myopia in these children often occurs at school age or before. This study aimed to identify risk factors for axial length (AL) elongation (elongating of the eyeball) and incidence of school myopia. Faster AL is the primary ocular component in myopia progression. The study was based on the understanding that identifying risk factors for eye growth at a young age may help characterize children at high risk of myopia for whom lifestyle advice and interventions could be helpful.
Children participating in this study were part of a population-based prospective cohort study (referred to as the Generation R Study) of pregnant women and their children in Rotterdam, The Netherlands. Generation R children – all born between April 2002 and January 2006 -- were invited at 6 and 9 years of age to be examined at a research center. The examination pertinent to this study focused on eye health, daily life activities, and demographic characteristics. Researchers used this data to investigate the effect of a large set of variables measured in children at 6 years of age on eye health at 9 years of age. From this data, they were able to develop a risk score for developing myopia. This score considered both environmental and ocular factors.
A total of 4734 children underwent comprehensive eye examinations at both 6 and 9 years of age. Children with myopia at the age of 9 showed significantly greater axial elongation (AL) compared with children without myopia. Less time outdoors was one of seven factors associated with faster AL elongation. Attention to these factors can help identify school children at risk of myopia. Because some of these factors relate to lifestyle, changes in behavior – including spending more time outdoors – may offer some protection against developing myopia. This may be particularly true for children at greater risk for myopia.
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