As myopia cases rise across the world—and with an acute trend reported in Asian countries— researchers race to find ways to curb the condition’s proliferation. Delving into this effort, a new study found that adults with high myopia appeared to have some commonalities when they were children. Specifically, the researchers found adult high myopes generally got their first pair of spectacle lenses at an earlier age, had a higher refractive power in their original set of glasses, had a mother with high myopia and participated in after school programs in high school.

The study, which was based in Taiwan, enrolled 331 adults between the ages of 20 and 45 who completed a questionnaire about their age, gender, current refractive error, parental high myopia status, early onset of myopia by the age of the first myopic spectacle prescription, refractive power of their first pair of glasses and life habits at different educational stages. The researchers then analyzed associations between these factors and high myopia in adulthood.

The average refractive error was -4.03D, and high myopia was noted in about 28% of the study participants.

Looking at parental influence, roughly 3% of subjects had fathers with high myopia, while 6% had mothers with high myopia. The participants received their first myopic spectacle prescription when they were approximately 13 years old, with a mean refractive error of -1.63D.

Additionally, individuals who began spectacle wear before they were nine were more likely to develop high myopia as adults compared with those who received their first pair of glasses when they were 13 or older.

Another finding that has been echoed in previous literature: those who developed high myopia spent less time outdoors when they were kids.

“This is the first report that the reception of the first spectacle prescription at an earlier age was a biomarker of the early onset of myopia for predicting high myopia in later life,” the researchers wrote in their paper. “Therefore, the onset of school myopia should be delayed as much as possible by some interventions to reduce the prevalence of high myopia and its public health impact.”