Final report - Risk factors for eye disease and injury
Table 4.3 Summary of results for refractive error
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Risk factor | Condition | Finding | Group a | Summary sheet |
| Alcohol consumption | Myopia | No relevant studies found | 7 | NA |
| Alcohol consumption | Hyperopia | No relevant studies found | 7 | NA |
| Alcohol consumption | Astigmatism | No relevant studies found | 7 | NA |
| Alcohol consumption | Presbyopia | No relevant studies found | 7 | NA |
| Eye infections | Myopia | No relevant studies found | 7 | NA |
| Eye infections | Hyperopia | No relevant studies found | 7 | NA |
| Eye infections | Astigmatism | No relevant studies found | 7 | NA |
| Eye infections | Presbyopia | No relevant studies found | 7 | NA |
| Age/ageing | Myopia | Myopia increases with age up to the age of 30, and again for people over the age of 70. | 1 | 167 |
| Age/ageing | Hyperopia | Hyperopia appears to increase with age up to the age of 70. Some studies report a stabilising and then a further increase with extreme old age, whereas others report a shift to myopia between 70 and 85 years. | 2 | 168 |
| Age/ageing | Astigmatism | It is not clear whether ageing affects the incidence of astigmatism or just the type of astigmatism present. | 5 | 169 |
| Age/ageing | Presbyopia | Link already established | 170 | |
| UV damage | Myopia | No relevant studies found | 7 | NA |
| UV damage | Hyperopia | No relevant studies found | 7 | NA |
| UV damage | Astigmatism | No relevant studies found | 7 | NA |
| UV damage | Presbyopia | No relevant studies found | 7 | NA |
| Diabetes | Myopia | Diabetes does not appear to be a risk factor for myopia. | 4 | 175 |
| Diabetes | Hyperopia | Diabetes can cause transient hyperopia. This effect is corrected when hyperglycaemia is corrected. | 2 | 176 |
| Diabetes | Astigmatism | No relevant studies found | 7 | NA |
| Diabetes | Presbyopia | No relevant studies found | 7 | NA |
| Heredity | Myopia | High myopia may have a genetic link, but more research is needed. | 2 | 179 |
| Heredity | Hyperopia | No relevant studies found | 7 | NA |
| Heredity | Astigmatism | Heredity may be a predisposing factor for astigmatism. | 2 | 181 |
| Heredity | Presbyopia | No relevant studies found | 7 | NA |
| Hyperopia | Myopia | No relevant studies found | 7 | NA |
| Hyperopia | Astigmatism | No relevant studies found | 7 | NA |
| Hyperopia | Presbyopia | Hyperopia may predispose to early development of presbyopia in normal individuals. | 2 | 186 |
| Near-vision work | Myopia | The studies are not sufficient to examine in detail the relationship between the effect of near work and incidence and progression of myopia. Two studies suggest that near work has less effect than heredity; one study suggests that intensive near work could initiate myopia or lead to its progression in young adults. Further longitudinal studies are needed to examine the effect of near work. | 2 | 187 |
| Near-vision work | Hyperopia | No relevant studies found | 7 | NA |
| Near-vision work | Astigmatism | No relevant studies found | 7 | NA |
| Near-vision work | Presbyopia | No relevant studies found | 7 | NA |
| Ocular disease | Myopia | Nuclear opacities (cataract) and glaucoma (and ocular hypertension) may increase the risk of myopia. Further studies are needed to examine the effect of ocular diseases on myopia. Untreated retinopathy of prematurity (ROP) leads to a high incidence of myopia in adults. | 2 | 191 |
| Ocular disease | Hyperopia | Hyperopia incidence decreased with incidence of glaucoma and ocular hypertension. | 6 | 192 |
| Ocular disease | Astigmatism | Grave’s ophthalmopathy may be associated with greater with-the-rule (horizontal) astigmatism. However, given the low prevalence of Grave’s ophthalmopathy, it is unlikely to be a significant risk factor for astigmatism in the general population. | 2 | 193 |
| Ocular disease | Presbyopia | No relevant studies found | 7 | NA |
| Trauma | Myopia | No relevant studies found | 7 | NA |
| Trauma | Hyperopia | No relevant studies found | 7 | NA |
| Trauma | Astigmatism | Although rare, a wound can lead to secondary problems, such as lenticular astigmatism. | 2 | 197 |
| Trauma | Presbyopia | No relevant studies found | 7 | NA |
| Antidepressants | Myopia | No relevant studies found | 7 | NA |
| Antidepressants | Hyperopia | No relevant studies found | 7 | NA |
| Antidepressants | Astigmatism | No relevant studies found | 7 | NA |
| Antidepressants | Presbyopia | No relevant studies found | 7 | NA |
| Antihistamines | Myopia | No relevant studies found | 7 | NA |
| Antihistamines | Hyperopia | No relevant studies found | 7 | NA |
| Antihistamines | Astigmatism | No relevant studies found | 7 | NA |
| Antihistamines | Presbyopia | No relevant studies found | 7 | NA |
| Warm climate | Myopia | No relevant studies found | 7 | NA |
| Warm climate | Hyperopia | No relevant studies found | 7 | NA |
| Warm climate | Astigmatism | No relevant studies found | 7 | NA |
| Warm climate | Presbyopia | No relevant studies found | 7 | NA |
| Excessive reading | Myopia | There are conflicting results about the relationship between reading and other near work and development of myopia. | 5 | 211 |
| Excessive reading | Hyperopia | No relevant studies found | 7 | NA |
| Excessive reading | Astigmatism | No relevant studies found | 7 | NA |
| Excessive reading | Presbyopia | No relevant studies found | 7 | NA |
| Computer or TV | Myopia | There appears to be no relationship between computer and television (TV) use and myopia, although further prospective studies would be useful to confirm this result. However, ‘near work’ such as reading and writing or practical near work is associated with a refractive change towards myopia (see summary table 211). (In one study, sport was protective for myopia development.) | 4 | 215 |
| Computer or TV | Hyperopia | In one study of visual display unit operators, extended use of visual display units caused a slight tendency toward hyperopia, but there is no other research data to support or refute this finding. | 2 | 216 |
| Computer or TV | Astigmatism | No relevant studies found | 7 | NA |
| Computer or TV | Presbyopia | No relevant studies found | 7 | NA |
| Diet | Myopia | The link between a high glycaemic diet and myopia remains a theory but would be an interesting area for future research. | 2 | 240 |
| Diet | Hyperopia | No relevant studies found | 7 | NA |
| Diet | Astigmatism | No relevant studies found | 7 | NA |
| Diet | Presbyopia | No relevant studies found | 7 | NA |
| Fatty acids | Myopia | No relevant studies found | 7 | NA |
| Fatty acids | Hyperopia | No relevant studies found | 7 | NA |
| Fatty acids | Astigmatism | No relevant studies found | 7 | NA |
| Fatty acids | Presbyopia | No relevant studies found | 7 | NA |
| Obesity | Myopia | No relevant studies found | 7 | NA |
| Obesity | Hyperopia | Obesity may be a risk factor for hyperopia, although more research is required in this area. | 2 | 233 |
| Obesity | Astigmatism | No relevant studies found | 7 | NA |
| Obesity | Presbyopia | No relevant studies found | 7 | NA |
a Groups are as follows:
Group 1 — Clear association/causality
Group 2 — Possible association/causality (more research needed)
Group 3 — Lack of association/causality
Group 4 — Possible lack of association/causality (more research needed)
Group 5 — Conflicting results
Group 6 — Possible protection
Group 7 — No studies
b Summary sheets number refers to the results tables in Appendix 3.
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