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Prevalence of myopia among urban and suburban school children in Tamil Nadu, South India: findings from the Sankara Nethralaya Tamil Nadu Essilor Myopia (STEM) Study


Aparna Gopalakrishnan, Jameel Rizwana Hussaindeen, Viswanathan Sivaraman, Meenakshi Swaminathan, Yee Ling Wong, James A Armitage, Alex Gentle, Simon Backhouse


Essilor International, Singapore




Ophthalmic and Physiological Optics


  • The purpose of the study is to report the baseline prevalence of myopia among school children in Tamil Nadu, South India from a prospective cohort study.

  • Children between the ages of 5 and 16 years from 11 schools in two districts of Tamil Nadu underwent vision screening. All children underwent visual acuity assessment using a Pocket Vision Screener followed by non-cycloplegic open-field autorefraction (Grand Seiko WAM-5500). 

  • Myopia was defined as a spherical equivalent (SE) refraction of ≤−0.75 D and high myopia was defined as SE ≤ −6.00 D. Distribution of refraction, biometry and factors associated with prevalence of myopia were the outcome measures.

  • A total of 14,699 children completed vision screening, with 2% (357) of them having ocular abnormalities other than refractive errors or poor vision despite spectacle correction. 

  • The remaining 14,342 children (7557 boys; 52.69%) had a mean age of 10.2 (Standard Deviation [SD] 2.8) years. A total of 2502 had myopia in at least one eye, a prevalence of 17.5% (95% CI: 14.7–20.5%), and 74 (0.5%; 95% CI: 0.3–0.9%) had high myopia. 

  • Myopia prevalence increased with age (p < 0.001), but sex was not associated with myopia prevalence (p = 0.24). Mean axial length (AL; 23.08 (SD = 0.91) mm) and mean anterior chamber depth (ACD; 3.45 (SD = 0.27) mm) positively correlated with age (p < 0.001). 

  • The mean flat (K1; 43.37 (SD = 1.49) D) and steep (K2; 44.50 (SD = 1.58) D) corneal curvatures showed negative correlation with age (p = 0.02 and p < 0.001, respectively). In the multivariable logistic regression, older age and urban school location had higher odds for prevalence of myopia.

  • The baseline prevalence of myopia among 5- to 16-year-old children in South India is larger than that found in previous studies, indicating that myopia is becoming a major public health problem in this country.