Prevalence and Possible Factors of Myopia in Norwegian Adolescents

Abstract

East Asia has experienced an excessive increase in myopia in the past decades with more than 80% of the younger generation now affected. Environmental and genetic factors are both assumed to contribute in the development of refractive errors, but the etiology is unknown. The environmental factor argued to be of greatest importance in preventing myopia is high levels of daylight exposure. If true, myopia prevalence would be higher in adolescents living in high latitude countries with fewer daylight hours in the autumn-winter. We examined the prevalence of refractive errors in a representative sample of 16–19-year-old Norwegian Caucasians (n = 393, 41.2% males) in a representative region of Norway (60° latitude North). At this latitude, autumn-winter is 50 days longer than summer. Using gold-standard methods of cycloplegic autorefraction and ocular biometry, the overall prevalence of myopia [spherical equivalent refraction (SER) ≤−0.50 D] was 13%, considerably lower than in East Asians. Hyperopia (SER ≥ + 0.50 D), astigmatism (≥1.00 DC) and anisometropia (≥1.00 D) were found in 57%, 9% and 4%. Norwegian adolescents seem to defy the world-wide trend of increasing myopia. This suggests that there is a need to explore why daylight exposure during a relatively short summer outweighs that of the longer autumn-winter.