Abstract
SIGNIFICANCE: Adult onset and progression of myopia are not well understood. It is of interest to better characterize myopia progression in young adults, who are frequently subjected to risk factors, such as intense near-work demands. PURPOSE: This study aimed to assess the prevalence and progression of myopia and other refractive errors in optometry students in the United States. METHODS: This study was a retrospective chart review of electronic medical records of students enrolled in the optometry program at the University of Houston College of Optometry who graduated between 2013 and 2023. For each student, refractive error was noted from the medical record for eye examinations during their time as an optometry student. Exclusion criteria were ocular disease, myopia control treatment, or refractive surgery. Prevalences of hyperopia (≥+ 0.50 D), emmetropia (>-0.50 to <+0.50 D), myopia (≤-0.50 D), astigmatism (>0.50 D), and anisometropia (≥1.0 D) were determined from spherical equivalent refraction (SER) of the right eye. Absolute and annualized differences in SER were calculated between visits. RESULTS: Records for 1071 students were reviewed, and 961 were included. Prevalences were 80.7% for myopia, 14.9% for emmetropia, and 4.4% for hyperopia. Additionally, 38.4% had astigmatism, and 16.1% had anisometropia. Students with one follow-up exam (n = 639) showed a significant negative change in SER of -0.05 ± 0.38 D over an average follow-up period of 1.60 ± 0.61 years (p=0.001). Myopia onset was observed in 15.7% of emmetropes at baseline. Greater negative SER change was associated with greater follow-up duration and younger age. Hyperopes and emmetropes did not demonstrate significant changes in SER. An annualized negative SER change of ≥-0.25 D was noted in 20% of the 639 students, of which 5.5% showed ≥-0.50 D. CONCLUSIONS: Findings demonstrate a high prevalence of myopia among optometry students. A small but statistically significant myopic change in refraction was observed. These findings may implicate a role of education and near work in myopia.