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This study aim described the change in myopia prevalence in middle\u2010aged Australian adults over approximately a 20\u2010year period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two contemporary Western Australian studies (conducted in mid\u2010late 2010s): the coastal\u2010regional Busselton Healthy Ageing Study (BHAS) and the urban Gen1 of the Raine Study (G1RS) were compared to two earlier studies (early\u2010mid 1990s) in Australia: the urban Blue Mountains Eye Study (BMES) and urban\/regional Melbourne Visual Impairment Project (MVIP). Refractive error was measured by autorefraction, vertometry, or subjective refraction. Participants (49\u201370\u2009years) of European descent without self\u2010reported\/diagnosed cataract, corneal disease, or refractive or corneal surgery were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After exclusions, data were available from 2217, 1760, 700, 2987 and 756 participants from BMES, urban MVIP, regional MVIP, BHAS, and G1RS, respectively. The mean age ranged from 57.1\u2009\u00b1\u20094.6\u2009years in the G1RS to 60.1\u2009\u00b1\u20096.0\u2009years in the BMES; 44\u201348% of participants were male. When stratified by location, the contemporary urban G1RS cohort had a higher age\u2010standardised myopia prevalence than the urban MVIP and BMES cohorts (29.2%, 16.4%, and 23.9%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001). The contemporary coastal\u2010regional BHAS had a higher age\u2010standardised myopia prevalence than the regional MVIP cohort (19.4% vs. 13.8%, <jats:italic>p<\/jats:italic>\u00a0=\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We report an increase in myopia prevalence in older adults in Australia born after World War ll compared to cohorts born before, accounting for urban\/regional location. The prevalence of myopia remains relatively low in middle\u2010aged Australian adults.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ceo.13980","type":"journal-article","created":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T03:41:52Z","timestamp":1628653312000},"page":"1039-1047","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Change in the prevalence of myopia in Australian middle\u2010aged adults across 20\u2009years"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7914-4709","authenticated-orcid":false,"given":"David A.","family":"Mackey","sequence":"first","affiliation":[{"name":"Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute) University of Western Australia  Perth Western Australia 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