ORCID

Abstract

ObjectiveMyopia prevalence is rising globally and has reached critical levels in some regions. Beyond refractive correction needs, myopia is a major risk factor for irreversible, vision-threatening ocular disease. This study investigated the relationship between myopia, age, sex, and visual impairment in two nationally representative populations in the United States and South Korea.DesignCross-sectional analysis using data from the U.S. National Health and Nutrition Examination Survey (NHANES) and the Korean National Health and Nutrition Examination Survey (KNHANES).ParticipantsParticipants in the NHANES and KNHANES.MethodsBest-corrected visual acuity and non-cycloplegic refractive error were analyzed from NHANES (1999–2008) and KNHANES (2008–2022), excluding those with cataract or refractive surgery. Visual impairment was defined as best-corrected visual acuity ≥0.30 LogMAR. Logistic regression and Kaplan–Meier analyses were used to evaluate and visualize the cumulative risk of visual impairment by refractive error age and sex.Main Outcome MeasureVisual impairment probability and the Odds Ratios for visual impairment by region, age and degree of myopia.ResultsVisual impairment rates increased with both myopia severity and age in both populations. Among younger non-myopes, impairment affected 1%, rising to 50% in high myopes by age 75. High myopes had up to 13-fold higher odds of visual impairment than non-myopes. Age-related risks were similar across regions, but myopia had a stronger effect in South Korea: each 1 D increase in myopia raised the odds of impairment by 41% versus 27% in the USA. Sex was not a significant factor in the U.S. (p = 0.207) but was significant in South Korea (OR: 1.69, 95% CI: 1.33–2.14, p < 0.01).ConclusionsMyopia substantially increases the risk of visual impairment in both the United States and South Korea, with risk rising proportionally with myopia severity. Age-related effects were similar across cohorts, though myopia exerted a greater influence in South Korea. Females demonstrated higher rates of visual impairment independently of refractive error. These findings highlight myopia as a global health concern, reinforcing the need for prevention and early intervention to reduce lifetime risk across all severities.

Keywords

Myopia, visual impairment, refractive error, NHANES, KNHANES

Publication Date

2026-03-04

Publication Title

Ophthalmology Science

Volume

2026

Deposit Date

2026-04-23

Funding

The authors made the following disclosure(s): I.F.: Grants ― 2024-present Co-PI Health Research Board (HRB), Achieving a clear vision for myopia care in Ireland with secondary data; Consultant ― Thea, Johnson & Johnson, Vyluma, Dopavision, Cooper- vision; Travel expenses ― Coopervision, Vyluma; Patents ― patents pending for myopia treatment monitoring, patents pending for myopia progression monitoring; Leadership ― Chair for two International Myopia Institute white paper committees; Stock ― Ocumetra Limited; Receipt of equipment ― Vyluma, Topcon. J.L.: Grants ― Coopervision, EssilorLuxottica, Ocumension, Dopavision; Patents ― patents pending for myopia treatment monitoring, patents pending for myopia progression monitoring; Participation on a Data Safety Monitoring Board ― Dopavision, EssilorLuxottica; Stock ― Ocumetra Limited. M.M.: Grants ― 2024-present Co-PI Health Research Board (HRB), Achieving a clear vision for myopia care in Ireland with secondary data; Consultant ― Thea Pharmaceuticals Support for Open Access publication was provided by Technological University Dublin

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