By Jayla Hamilton
In 2023, a systematic scoping review published in the Journal of Clinical Medicine analyzed the prevalence and progression of high myopia across various racial groups in the United States. This revealed significant differences among ethnicities, with the prevalence of high myopia ranging from 1.8% among Hispanic populations to 11.8% among Chinese populations. The disparity may be attributed to differing definitions of high myopia (≤−5.00 D vs. ≤−6.00 D), the time periods of the studies, and the criteria for participant selection.
Understanding these disparities is essential for public health strategies to effectively address and manage myopia-related risks in diverse communities, especially with 5.6 to 14.4 million people in the U.S. potentially affected by the disease. Below, we take a closer look at the related research.
The 2023 review also revealed that myopia is rising at an alarming rate among specific ethnic groups in the U.S. This suggests that Asian Americans, particularly East and South Asians, have a higher rate of myopia progression compared to Caucasians and African Americans. This difference in progression rates may be influenced by a combination of genetic, environmental, and behavioral factors.
2021 research published in Investigative Ophthalmology & Visual Science (IOVS) supports these findings. This found that the rate of myopia progression in Asian children is almost twice that of Caucasian children. Nevertheless, Caucasians, alongside African Americans and Hispanics, are not immune to its effects. Caucasian Americans still experienced moderate progression rates, suggesting that environmental factors such as screen time and outdoor exposure may also play a critical role alongside genetic factors.
The early onset and rapid progression could potentially increase the risk of developing high myopia later in life, leading to a greater susceptibility to sight-threatening conditions, such as retinal detachment and primary open-angle glaucoma (POAG). Further evidence in 2023 would add that although Chinese Americans had a higher prevalence of high myopia, the risk of developing primary open-angle glaucoma was significantly greater in Latino Americans. This highlighted that longer axial length, a common feature of high myopia, was more strongly associated with POAG risk than the degree of myopia itself. These findings thus suggest that ethnic differences in ocular structure and genetic predisposition might contribute to an increased risk of POAG among certain ethnic groups, despite similar levels of myopia. Understanding these differences is critical for creating targeted interventions to reduce the risk of myopia-associated complications in vulnerable populations.
Given the potential dangers associated with myopia, effective management strategies are crucial. The most common and accessible method for managing myopia is the use of prescription glasses, which provide immediate correction by refracting light properly onto the retina. The availability of online retailers has improved accessibility to prescription glasses, with Glasses offering a range of brands and styles to suit individual preferences, whether it's sportier eyewear from Oakley or more classic frames from Coach. Individuals with myopia can simply upload their prescriptions online and then use their insurance benefits to cover part or all of the costs.
Beyond corrective eyewear, lifestyle modifications also play a crucial role in managing myopia progression. Our previous article emphasized how wearing sunglasses can help prevent conditions like macular degeneration and cataracts, which are known to be exacerbated by UV exposure. Similarly, sunglasses also help in managing myopia by reducing the strain caused by bright light, especially in outdoor settings. Otherwise, adopting a balanced lifestyle includes annual eye check-ups, a diet rich in eye-health nutrients, and sufficient time outdoors. Reducing prolonged screen time and implementing practices such as the 20-20-20 rule can also help alleviate digital eye strain, a contributing factor to myopia progression.
As the prevalence of myopia continues to rise worldwide, understanding the ways that ethnicity, lifestyle, and genetics affect the disease will be vital in ensuring equitable access to vision care for all.