With myopia control efforts increasingly viable in clinical practice, understanding its course becomes more valuable to practitioners, especially in light of the ongoing worldwide increase in prevalence.

Dutch researchers recently investigated myopia progression from children to adults to study the natural history of the condition from the first prescription to the final refractive error. Myopia was defined as a spherical equivalent of refraction (SER) of -0.5 D or worse of the prescribed glasses and high myopia was defined as ≤-6.0 D.

A total of 2,555 people met the eligibility criteria of at least two orders of myopic eyeglasses by age 25.

Those with first prescription before the age of 10 showed the strongest progression (-0.50 D) and a significantly more negative median final SER (-4.48 D). All children who developed SER ≤-3D at 10 years were highly myopic (SER ≤-6D) as adults, children who had SER between -1.5D and -3D at 10 years had a 46% risk of high myopia, and children with SER between -0.5D and -1.5D had 32.6% risk of high myopia. Myopia progression diminished with age.

The authors conclude these results present the risk of high myopia in childhood, with SER at 10 years being an important prognostic indicator and may serve as a guide for treatment outcomes.

“All persons with SER -3D at 10 years developed high myopia by adult age,” the authors noted in their paper on the study. “We think this degree of refractive error developed in the first decade can serve as an indicator for professionals to maximize myopia control and lifestyle advice to reduce final refractive error. Unfortunately, lower refractive errors at age 10 did not exclude development of high myopia; hence, all children with a first myopic prescription below 10 years of age should be followed with care.”

Polling JR, Klaver C, Tideman JW. Myopia progression from wearing first glasses to adult age: the DREAM study. Br J Ophthalmol. December 25, 2020 [Epub ahead of print]. doi:10.1136/ bjophthalmol-2020-316234