Research Review

Myopia Progression in Adults

March 1, 2024

By Hashim Ali Khan, OD, FAAO, DiplAAO, PhD Candidate at Brien Holden Vision Institute

myopia progression in adults

Photo credit: Digital Vision, Getty Images

Myopia progression is associated with an increased risk of complications. While the progression of myopia during childhood is well documented, much is yet to be learned about the progression and associated risk factors in adulthood. Khan et al. retrospectively analyzed a large clinical dataset of subjective refraction results from 700 eyes of 354 young adult myopes (age range 18-30 years). 

The mean annual myopia progression was -0.10 [0.21] D, -0.08 [0.2] D, and -0.04 [0.21] D in 18-21-year, 22-26-year, and 27-30-year age groups, respectively (P = .003). The difference between the 18-21 years age group and the 27-30 years age group was significant (P=.05), and all other pairwise comparisons were not significant. The proportion (95%CI) of those who progressed by -0.25D/year or more was 18.3% (14.9, 21.7) in the 18-21 years age group, 10.9% (7.1, 14.7) in the 22-26 years age group and 8.8% (4.4, 13.1) in those who were older than 27 years of age. 

Annual progression or proportion of progressors was not influenced by gender and ethnicity. In contrast, both the annual progression and proportion of progressors were higher in those in an occupation related to higher learning/academic environment and thus had a greater demand for near visual workload. 

These findings support that myopia progression in young adults is a function of age and is influenced by greater visual workload. For the majority, it appears myopia stabilizes around the age of 21 years and does not progress at substantial rates beyond this. However, a small yet significant proportion of young adults progress by at least -0.25D/year, thus requiring more frequent optometric eye exams. The findings from this study need further validation in well-designed prospective studies to comprehend better the effect of different risk factors on myopia progression in this age group. 



Myopia Progression in Adults: A Retrospective Analysis

Hashim Ali Khan, Thomas Naduvilath, Nina Tahhan, Padmaja R Sankaridurg 

Significance: Studies on adult myopia progression are limited. This retrospective analysis of a large data set of young adult myopes characterizes myopia progression during adulthood.

Purpose: This study aimed to determine the mean annual progression of myopia and to estimate the proportion of progressors in adult myopes.

Methods: Longitudinal, noncycloplegic subjective refraction data for young adult myopes (spherical equivalent refractive error, -0.50 D or more), age ranging from 18 to 30 years, were retrospectively analyzed. The mean annual progression, as well as the proportion of progressors (at least -0.50 D shift between visits and annualized progression of -0.25 D or more), was estimated.

Results: A total of 354 myopes (230 females [64.7%]), with a mean (standard deviation) age of 22.2 (3.8) years, were considered. The mean (standard deviation) annualized progression was -0.10 (0.21), -0.08 (0.2), and -0.04 (0.21) D in the 18- to 21-year, 22- to 26-year, and 27- to 30-year age groups, respectively (P = .003). The difference between 18- to 21- and 27- to 30-year age groups was significant (P = .05), whereas all other pairwise comparisons were not significant. The proportion (95% confidence interval) of progressors in the 18- to 21-, >21- to 26-, and >26- to 30-year age groups was 18.3% (14.9 to 21.7%), 10.9% (7.1 to 14.7%), and 8.8% (4.4 to 13.1%), respectively. The proportion of progressors working or studying in a higher learning/academic environment was 16.2% with an odds ratio (95% confidence interval) for progression of 2.07 (1.15 to 3.74) compared with those in nonacademic environments (P = .02), with no significant effect of sex or ethnicity.

Conclusions: This study is consistent with other studies on myopia in young adults, which show that myopia does not progress by substantial amounts throughout the adult years, particularly after the age of 21 years. Although future studies may be challenged by the small rates of change and the small proportion of progressors, further research is needed to understand the implications of adult myopia progression on clinical management.

Khan, H. A., Naduvilath, T., Tahhan, N., & Sankaridurg, P. R. (2023). Myopia Progression in Adults: A Retrospective Analysis. Optometry and Vision Science, 100(8), 537-542.              



Hashim Ali Khan is a current PhD candidate working on Adult Myopia with Prof. Padmaja Sankaridurg, Dr. Nina Tahhan, and A/Prof. Thomas Naduvilath, at the Brien Holden Vision Institute, University of New South Wales, Sydney.



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