What Factors are Associated with Myopia in Young Adults? A Survey Study in Taiwan Military Conscripts

PURPOSE: We investigated the independent impact of potential risk factors on myopia in young adults. METHODS: A survey study was conducted with male military conscripts aged 18 to 24 years between February 2010 and March 2011 in Taiwan. The participants were examined using non-cycloplegic autorefraction and biometry. The participants provided data about potential risk factors, including age, parental myopia, education, near work, outdoor activity, and urbanization. Myopia was defined as the mean spherical equivalent of the right eye of ≤ 0.5 diopters (D). RESULTS: Among 5145 eligible participants, 5048 (98.11%) had refraction and questionnaire data available; 2316 (45.88%) of these received axial length examination. The prevalence of myopia was 86.1% with a mean refractive error of -3.66 D (SD = 2.73) and an axial length of 25.40 mm (SD = 1.38). Older age, having myopic parents, higher education level, more time spent reading, nearer reading distance, less outdoor activity, and higher urbanization level were associated with myopia and longer axial length. More computer use was related to longer axial length. All risk factors associated with myopia also were predictors of high myopia (≤ -6.0 D), with the exception of outdoor activity. Finally, an interaction analysis showed shorter axial length was associated with more time spent outdoors only at high urbanization level. CONCLUSIONS: Older age, parental myopia, higher education level, more near work, less outdoor activity, and higher urbanization level were independent predictors of myopia. These data provided evidence to the multifactorial nature of myopia in young men in Taiwan.