Risk factors for eye disease and injury: literature review

Table 4.3 Summary of results for refractive error

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Risk factor

Condition

Finding

Group a

Summary sheet
number b

Alcohol consumptionMyopiaNo relevant studies found7NA
Alcohol consumptionHyperopiaNo relevant studies found7NA
Alcohol consumptionAstigmatismNo relevant studies found7NA
Alcohol consumptionPresbyopiaNo relevant studies found7NA
Eye infectionsMyopiaNo relevant studies found7NA
Eye infectionsHyperopiaNo relevant studies found7NA
Eye infectionsAstigmatismNo relevant studies found7NA
Eye infectionsPresbyopiaNo relevant studies found7NA
Age/ageingMyopiaMyopia increases with age up to the age of 30, and again for people over the age of 70.1167
Age/ageingHyperopiaHyperopia 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.2168
Age/ageingAstigmatismIt is not clear whether ageing affects the incidence of astigmatism or just the type of astigmatism present.5169
Age/ageingPresbyopiaLink already established170
UV damageMyopiaNo relevant studies found7NA
UV damageHyperopiaNo relevant studies found7NA
UV damageAstigmatismNo relevant studies found7NA
UV damagePresbyopiaNo relevant studies found7NA
DiabetesMyopiaDiabetes does not appear to be a risk factor for myopia.4175
DiabetesHyperopiaDiabetes can cause transient hyperopia. This effect is corrected when hyperglycaemia is corrected.2176
DiabetesAstigmatismNo relevant studies found7NA
DiabetesPresbyopiaNo relevant studies found7NA
HeredityMyopiaHigh myopia may have a genetic link, but more research is needed.2179
HeredityHyperopiaNo relevant studies found7NA
HeredityAstigmatismHeredity may be a predisposing factor for astigmatism.2181
HeredityPresbyopiaNo relevant studies found7NA
HyperopiaMyopiaNo relevant studies found7NA
HyperopiaAstigmatismNo relevant studies found7NA
HyperopiaPresbyopiaHyperopia may predispose to early development of presbyopia in normal individuals.2186
Near-vision workMyopiaThe 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.2187
Near-vision workHyperopiaNo relevant studies found7NA
Near-vision workAstigmatismNo relevant studies found7NA
Near-vision workPresbyopiaNo relevant studies found7NA
Ocular diseaseMyopiaNuclear 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.2191
Ocular diseaseHyperopiaHyperopia incidence decreased with incidence of glaucoma and ocular hypertension. 6192
Ocular diseaseAstigmatismGrave’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.2193
Ocular diseasePresbyopiaNo relevant studies found7NA
TraumaMyopiaNo relevant studies found7NA
TraumaHyperopiaNo relevant studies found7NA
TraumaAstigmatismAlthough rare, a wound can lead to secondary problems, such as lenticular astigmatism. 2197
TraumaPresbyopiaNo relevant studies found7NA
AntidepressantsMyopiaNo relevant studies found7NA
AntidepressantsHyperopiaNo relevant studies found7NA
AntidepressantsAstigmatismNo relevant studies found7NA
AntidepressantsPresbyopiaNo relevant studies found7NA
AntihistaminesMyopiaNo relevant studies found7NA
AntihistaminesHyperopiaNo relevant studies found7NA
AntihistaminesAstigmatismNo relevant studies found7NA
AntihistaminesPresbyopiaNo relevant studies found7NA
Warm climateMyopiaNo relevant studies found7NA
Warm climateHyperopiaNo relevant studies found7NA
Warm climateAstigmatismNo relevant studies found7NA
Warm climatePresbyopiaNo relevant studies found7NA
Excessive readingMyopiaThere are conflicting results about the relationship between reading and other near work and development of myopia.5211
Excessive readingHyperopiaNo relevant studies found7NA
Excessive readingAstigmatismNo relevant studies found7NA
Excessive readingPresbyopiaNo relevant studies found7NA
Computer or TVMyopiaThere 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.)
4215
Computer or TVHyperopiaIn 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.2216
Computer or TVAstigmatismNo relevant studies found7NA
Computer or TVPresbyopiaNo relevant studies found7NA
DietMyopiaThe link between a high glycaemic diet and myopia remains a theory but would be an interesting area for future research.2240
DietHyperopiaNo relevant studies found7NA
DietAstigmatismNo relevant studies found7NA
DietPresbyopiaNo relevant studies found7NA
Fatty acidsMyopiaNo relevant studies found7NA
Fatty acidsHyperopiaNo relevant studies found7NA
Fatty acidsAstigmatismNo relevant studies found7NA
Fatty acidsPresbyopiaNo relevant studies found7NA
ObesityMyopiaNo relevant studies found7NA
ObesityHyperopiaObesity may be a risk factor for hyperopia, although more research is required in this area.2233
ObesityAstigmatismNo relevant studies found7NA
ObesityPresbyopiaNo relevant studies found7NA

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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