Myopia Onset in Children—and Adults 

Winston Prakash and colleagues from LV Prasad Eye Institute along with researchers from other eye institutes report the 15-year cumulative incidence of myopia and associated risk factors at 8% in the Andhra Pradesh Eye Disease Study (APEDS). 

Myopia also referred to as short-sightedness, is a refractive error where distant objects appear blurry—it is one of the most common refractive errors of the eye. It usually develops during childhood and progresses into adolescence due to an abnormal increase in the length of the growing eyeball. But a myopic shift can also occur in adults due to age-related changes in the eye.

The risk factors for myopia are often associated with genetic predisposition, lifestyle factors including reduced outdoor activity, and increased near work. The World Health Organization recognizes it as a major public health concern; projections note that 50% of the global population may be myopic by 2050. Then, a key question to ask is: how many new cases of myopia are added to the case load every year?

The Andhra Pradesh Eye Disease Study (APEDS) conducted between 1996 – 2000 is a population-based survey mapping vision loss various eye diseases in South India by LVPEI. The study provides an opportunity to assess how refractive errors can emerge emerge over time in a population.

Participants from the first phase, APEDS I (1996-2000), were followed up in the third phase of the study, APEDS III between 2012-2016. This interval makes it possible to identify people who did not have myopia at the start of the study but developed it during the period, providing information on its cumulative incidence. This measure provides insight into the risk of a disease in a population over time, which is necessary to implement control strategies.

In a new study published in Clinical and Experimental Optometry, Winston Prakash and colleagues from LVPEI report on the 15-year cumulative incidence of myopia and the risk factors associated with it in the rural population of Telangana and Andhra Pradesh. Of the 7,771 participants examined during APEDS I, 5395 were re-examined during APEDS III.

After excluding those who already had myopia at baseline and those with age-related changes in their eye lens, 2071 participants younger than 30 years (50.9% female) and 755 participants aged 30 years and above (52.6% female) at baseline were included in the analysis. All participants underwent a comprehensive eye examination, including visual acuity and refraction.   

Overall, 8% developed myopia over the 15-year period.   While females had higher incidence of myopia among participants under 30 years of age, it was higher in males among those above 30 years of age. The researchers also noted that conditions like nuclear sclerosis (a type of cataract that causes myopic shift in adults) may contribute to a myopic shift in older populations.

‘Assessing the incidence of myopia can help us understand how new cases develop over time. With projections that half of the world’s population will be myopic by 2050, longitudinal data from studies like APEDS provide valuable insights to plan strategies to address the growing burden,’ says Dr. Rohit Khanna, Network Director, Public Health Department, LVPEI, and corresponding author of the paper. 

Citation

Prakash, W. D., Khanna, R. C., Marmamula, S., Mettla, A. L., Giridhar, P., Purohit, N., … Rao, G. N. (2026). Cumulative incidence of myopia and risk factors in rural south India: results from the Andhra Pradesh Eye Disease Study III. Clinical and Experimental Optometry, 109(7), 1500–1508. https://doi.org/10.1080/08164622.2026.2695842 

Photo Credit: Winston Prakash