Myopia progression from wearing first glasses to adult age: the DREAM Study

PURPOSE: Data on myopia progression during its entire course are scarce. The aim of this study is to investigate myopia progression in Europeans as a function of age and degree of myopia from first prescription to final refractive error. METHODS: The Drentse Refractive Error and Myopia Study assessed data from a branch of opticians in the Netherlands from 1985 onwards in a retrospective study. First pair of glasses prescribed was defined as a spherical equivalent of refraction (SER) ≤−0.5 D to ≥−3.0 D. Subjects with prescriptions at an interval of at least 1 year were included in the analysis. RESULTS: A total of 2555 persons (57.3% female) met the inclusion criteria. Those with first prescription before the age of 10 years showed the strongest progression (−0.50 D; IQR: −0.75 to −0.19) and a significantly (p<0.001) more negative median final SER (−4.48 D; IQR: −5.37 to −3.42). All children who developed SER ≤−3 D at 10 years were highly myopic (SER ≤−6D) as adults, children who had SER between −1.5 D and −3 D at 10 years had 46.0% risk of high myopia, and children with SER between −0.5 D and −1.5 D had 32.6% risk of high myopia. Myopia progression diminished with age; all refractive categories stabilised after age 15 years except for SER ≤−5 D who progressed up to −0.25 D annually until age 21 years. CONCLUSION: Our trajectories of the natural course of myopia progression may serve as a guide for myopia management in European children. SER at 10 years is an important prognostic indicator and will help determine treatment intensity.