Myopia and its progression in children in London, UK: a retrospective evaluation

PURPOSE: : Worldwide, the prevalence of myopia is increasing. Myopia begins at younger ages and progresses faster, leading to more adults with high myopia and risk of sight-threatening complications. No data are available about myopia trends in children in urban areas in the UK. We present a 10-year review of children attending a secondary and tertiary eye care facility in London, focussing on the proportion of glasses prescriptions for myopia and progression rates. METHODS: : We collated refraction and demographic data from children under the age of 17 years seen at Moorfields Eye Hospital, London, UK, between 2008 and 2017. RESULTS: : We included 63,854 datasets from 23,593 children (51.2% boys, median age 5.4 years, interquartile range IQR 3.8–7.1). The proportion of myopic prescriptions increased from 24 to 32%. In n = 3355 with initial mild/moderate myopia, median progression rate was −0.16 (−0.5 to 0.04) D/year. In those with progression (n = 2095), the rate was -0.40 (−0.19 to −0.74) D/year, slightly higher in girls than in boys (−0.42 vs −0.38 D/year; p = 0.02). Progression was faster in initial moderate than initial mild myopia (−0.54 vs −0.37 D/year; p < 0.001), and before than after average age of onset of puberty (−0.41 vs −0.35 D/year; p = 0.013). There was no statistically significant difference between children of different ethnic backgrounds. CONCLUSIONS: : In this cohort, the proportion of glasses prescriptions for myopia and the rate of progression are higher than previously reported for European countries. Living in an urban environment may result in similar progression rates despite different genetic backgrounds.