{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:01:36Z","timestamp":1790186496934,"version":"4.1.0"},"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T00:00:00Z","timestamp":1642550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>This study investigated temporal trends in the epidemiology of primary myopia and associations with key environmental risk factors in a UK population. Data were collected at recruitment (non-cycloplegic autorefraction, year of birth, sex, ethnicity, highest educational attainment, reason and age of first wearing glasses and history of eye disease) from 107,442 UK Biobank study participants aged 40 to 69 years, born between 1939 and 1970. Myopia was defined as mean spherical equivalent (MSE) \u2264-1 dioptre (D). Temporal changes in myopia frequency by birth cohort (5-year bands using date of birth) and associations with environmental factors were analysed, distinguishing both type (childhood-onset, &lt;18 years versus adult-onset) and severity (three categories: low -1.00 to -2.99D, moderate -3.00 to -5.99D or high \u2265-6.00D). Overall myopia frequency increased from 20.0% in the oldest cohort (births 1939\u20131944) to 29.2% in the youngest (1965\u20131970), reflecting a relatively higher increase in frequency of adult-onset and low myopia. Childhood-onset myopia peaked in participants born in 1950\u201354, adult-onset myopia peaked in the cohort born a decade later. The distribution of MSE only shifted for childhood-onset myopia (median: -3.8 [IQR -2.4, -5.4] to -4.4 [IQR -3.0, -6.2]). The magnitude of the association between higher educational attainment (proxy for educational intensity) and myopia overall increased over time (adjusted Odds Ratio (OR) 2.7 [2.5, 2.9] in the oldest versus 4.2 [3.3, 5.2] in the youngest cohort), being substantially greater for childhood-onset myopia (OR 3.3 [2.8, 4.0] to 8.0 [4.2, 13]). Without delineating childhood-onset from adult-onset myopia, important temporal trends would have been obscured. The differential impact of educational experience\/intensity on both childhood-onset and high myopia, amplified over time, suggests a cohort effect in gene-environment interaction with potential for increasing myopia frequency if increasing childhood educational intensity is unchecked. However, historical plateauing of myopia frequency does suggest some potential for effective intervention.<\/jats:p>","DOI":"10.1371\/journal.pone.0260993","type":"journal-article","created":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T18:23:39Z","timestamp":1642616619000},"page":"e0260993","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":26,"title":["Temporal trends in frequency, type and severity of myopia and associations with key environmental risk factors in the UK: Findings from the UK Biobank Study"],"prefix":"10.1371","volume":"17","author":[{"given":"Phillippa M.","family":"Cumberland","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2522-1582","authenticated-orcid":true,"given":"Vasiliki","family":"Bountziouka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Hammond","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pirro G.","family":"Hysi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5718-9209","authenticated-orcid":true,"given":"Jugnoo S.","family":"Rahi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the UK Biobank Eye and Vision Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,1,19]]},"reference":[{"key":"pone.0260993.ref001","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.exer.2013.02.008","article-title":"Is myopia a failure of homeostasis?","volume":"114","author":"DI Flitcroft","year":"2013","journal-title":"Experimental eye research"},{"issue":"1","key":"pone.0260993.ref002","doi-asserted-by":"crossref","first-page":"27","DOI":"10.47102\/https:\/\/doi.org\/10.47102\/annals-acadmedsg.V33N1p27","article-title":"Prevalence of myopia in Taiwanese schoolchildren: 1983 to 2000.","volume":"33","author":"LL Lin","year":"2004","journal-title":"Annals of the Academy of Medicine, Singapore."},{"issue":"9","key":"pone.0260993.ref003","doi-asserted-by":"crossref","first-page":"5711","DOI":"10.1167\/iovs.13-13693","article-title":"Generational difference of refractive error and risk factors in the Handan Offspring Myopia Study","volume":"55","author":"Z Lin","year":"2014","journal-title":"Investigative ophthalmology & visual science"},{"issue":"5","key":"pone.0260993.ref004","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/j.ophtha.2016.01.006","article-title":"Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050","volume":"123","author":"BA Holden","year":"2016","journal-title":"Ophthalmology"},{"issue":"1","key":"pone.0260993.ref005","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1475-1313.2011.00884.x","article-title":"Worldwide prevalence and risk factors for myopia","volume":"32","author":"CW Pan","year":"2012","journal-title":"Ophthalmic & physiological optics: the journal of the British College of Ophthalmic Opticians (Optometrists)."},{"issue":"8","key":"pone.0260993.ref006","doi-asserted-by":"crossref","first-page":"2760","DOI":"10.1167\/iovs.04-0260","article-title":"The changing prevalence of myopia in young adults: a 13-year series of population-based prevalence surveys","volume":"46","author":"Y Bar Dayan","year":"2005","journal-title":"Investigative ophthalmology & visual science"},{"issue":"12","key":"pone.0260993.ref007","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1001\/archophthalmol.2009.303","article-title":"Increased prevalence of myopia in the United States between 1971\u20131972 and 1999\u20132004","volume":"127","author":"S Vitale","year":"2009","journal-title":"Archives of ophthalmology"},{"issue":"7","key":"pone.0260993.ref008","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1016\/j.ophtha.2015.03.018","article-title":"Increasing Prevalence of Myopia in Europe and the Impact of Education","volume":"122","author":"KM Williams","year":"2015","journal-title":"Ophthalmology"},{"issue":"6","key":"pone.0260993.ref009","first-page":"497","article-title":"The increased prevalence of myopia in Finland.","volume":"90","author":"O. Parssinen","year":"2012","journal-title":"Acta"},{"key":"pone.0260993.ref010","first-page":"53","volume-title":"The Economic and Societal Impact of Myopia and High Myopia","author":"SYL Chua","year":"2020"},{"issue":"6","key":"pone.0260993.ref011","doi-asserted-by":"crossref","first-page":"431","DOI":"10.2471\/BLT.08.055673","article-title":"Potential lost productivity resulting from the global burden of uncorrected refractive error","volume":"87","author":"TS Smith","year":"2009","journal-title":"Bulletin of the World Health Organization"},{"issue":"4","key":"pone.0260993.ref012","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1111\/opo.12305","article-title":"Age of onset of myopia predicts risk of high myopia in later childhood in myopic Singapore children","volume":"36","author":"SY Chua","year":"2016","journal-title":"Ophthalmic & physiological optics: the journal of the British College of Ophthalmic Opticians (Optometrists)."},{"issue":"1","key":"pone.0260993.ref013","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.preteyeres.2004.06.004","article-title":"How genetic is school myopia?","volume":"24","author":"I Morgan","year":"2005","journal-title":"Progress in retinal and eye research"},{"issue":"5","key":"pone.0260993.ref014","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.ophtha.2010.09.025","article-title":"Myopia over the lifecourse: prevalence and early life influences in the 1958 British birth cohort","volume":"118","author":"JS Rahi","year":"2011","journal-title":"Ophthalmology"},{"issue":"9578","key":"pone.0260993.ref015","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.1016\/S0140-6736(07)60924-6","article-title":"UK Biobank: bank on it","volume":"369","author":"LJ Palmer","year":"2007","journal-title":"The Lancet"},{"issue":"3","key":"pone.0260993.ref016","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.hlpt.2012.07.003","article-title":"UK Biobank: Current status and what it means for epidemiology.","volume":"1","author":"N Allen","year":"2012","journal-title":"Health Policy and Technology"},{"key":"pone.0260993.ref017","unstructured":"UK Biobank. Enable Your Research [updated 2020, December 11th. Available from: https:\/\/www.ukbiobank.ac.uk\/enable-your-research."},{"issue":"10","key":"pone.0260993.ref018","doi-asserted-by":"crossref","first-page":"e0139780","DOI":"10.1371\/journal.pone.0139780","article-title":"Frequency and Distribution of Refractive Error in Adult Life: Methodology and Findings of the UK Biobank Study.","volume":"10","author":"PM Cumberland","year":"2015","journal-title":"PloS one."},{"issue":"10","key":"pone.0260993.ref019","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1136\/bjophthalmol-2017-311557","article-title":"Impact of varying the definition of myopia on estimates of prevalence and associations with risk factors: time for an approach that serves research, practice and policy","volume":"102","author":"PM Cumberland","year":"2018","journal-title":"The British journal of ophthalmology"},{"issue":"3","key":"pone.0260993.ref020","doi-asserted-by":"crossref","first-page":"M20","DOI":"10.1167\/iovs.18-25957","article-title":"IMI\u2014Defining and Classifying Myopia: A Proposed Set of Standards for Clinical and Epidemiologic Studies.","volume":"60","author":"DI Flitcroft","year":"2019","journal-title":"Investigative ophthalmology & visual science"},{"issue":"7","key":"pone.0260993.ref021","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1001\/jamaophthalmol.2016.1275","article-title":"Accuracy and Utility of Self-report of Refractive Error","volume":"134","author":"PM Cumberland","year":"2016","journal-title":"JAMA ophthalmology"},{"issue":"6","key":"pone.0260993.ref022","doi-asserted-by":"crossref","first-page":"e458","DOI":"10.1111\/aos.12388","article-title":"What is the appropriate age cut-off for cycloplegia in refraction?","volume":"92","author":"PG Sanfilippo","year":"2014","journal-title":"Acta ophthalmologica."},{"issue":"4","key":"pone.0260993.ref023","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1111\/j.1755-3768.2010.01983.x","article-title":"Validity of noncycloplegic refraction in the assessment of refractive errors: the Tehran Eye Study.","volume":"90","author":"A Fotouhi","year":"2012","journal-title":"Acta ophthalmologica."},{"issue":"1","key":"pone.0260993.ref024","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1001\/archophthalmol.2009.349","article-title":"Measuring refraction in adults in epidemiological studies","volume":"128","author":"EM Krantz","year":"2010","journal-title":"Archives of ophthalmology"},{"issue":"7","key":"pone.0260993.ref025","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1136\/bjophthalmol-2013-304228","article-title":"Prevalence of refractive errors in the European adult population: the Gutenberg Health Study (GHS).","volume":"98","author":"C Wolfram","year":"2014","journal-title":"The British journal of ophthalmology"},{"issue":"4","key":"pone.0260993.ref026","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s10654-015-0010-0","article-title":"Prevalence of refractive error in Europe: the European Eye Epidemiology (E(3)) Consortium.","volume":"30","author":"KM Williams","year":"2015","journal-title":"European journal of epidemiology"},{"key":"pone.0260993.ref027","doi-asserted-by":"crossref","first-page":"m131","DOI":"10.1136\/bmj.m131","article-title":"Comparison of risk factor associations in UK Biobank against representative, general population based studies with conventional response rates: prospective cohort study and individual participant meta-analysis","volume":"368","author":"D Batty G","year":"2020","journal-title":"BMJ"},{"issue":"8","key":"pone.0260993.ref028","doi-asserted-by":"crossref","first-page":"4363","DOI":"10.1167\/iovs.11-8677","article-title":"The association between time spent outdoors and myopia using a novel biomarker of outdoor light exposure","volume":"53","author":"JC Sherwin","year":"2012","journal-title":"Investigative ophthalmology & visual science"},{"issue":"10","key":"pone.0260993.ref029","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1016\/j.ophtha.2014.04.017","article-title":"Myopia and level of education: results from the Gutenberg Health Study","volume":"121","author":"A Mirshahi","year":"2014","journal-title":"Ophthalmology"},{"issue":"8","key":"pone.0260993.ref030","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1136\/bjo.2007.128256","article-title":"A comparison of measures of reading and intelligence as risk factors for the development of myopia in a UK cohort of children","volume":"92","author":"C Williams","year":"2008","journal-title":"The British journal of ophthalmology"},{"issue":"7","key":"pone.0260993.ref031","doi-asserted-by":"crossref","first-page":"2903","DOI":"10.1167\/iovs.07-0804","article-title":"Role of near work in myopia: findings in a sample of Australian school children.","volume":"49","author":"JM Ip","year":"2008","journal-title":"Investigative ophthalmology & visual science"},{"issue":"2","key":"pone.0260993.ref032","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1167\/iovs.07-1123","article-title":"The role of educational attainment in refraction: the Genes in Myopia (GEM) twin study.","volume":"49","author":"M Dirani","year":"2008","journal-title":"Investigative ophthalmology & visual science"},{"issue":"4","key":"pone.0260993.ref033","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1080\/13816810.2016.1232416","article-title":"Myopia-The future progression of myopia: Seeing where we are going","volume":"37","author":"DA Mackey","year":"2016","journal-title":"Ophthalmic genetics"},{"issue":"8","key":"pone.0260993.ref034","first-page":"2566","article-title":"Changes in refraction over 10 years in an adult population: the Beaver Dam Eye study.","volume":"43","author":"KE Lee","year":"2002","journal-title":"Investigative ophthalmology & visual science"},{"issue":"8","key":"pone.0260993.ref035","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1001\/archopht.126.8.1111","article-title":"Prevalence of refractive error in the United States, 1999\u20132004","volume":"126","author":"S Vitale","year":"2008","journal-title":"Archives of ophthalmology"},{"issue":"6","key":"pone.0260993.ref036","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1016\/S0161-6420(99)90251-8","article-title":"Refractive errors in an older population: the Blue Mountains Eye Study","volume":"106","author":"K Attebo","year":"1999","journal-title":"Ophthalmology"},{"issue":"4","key":"pone.0260993.ref037","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1097\/01.OPX.0000159358.71125.95","article-title":"Ametropia and ocular biometry in a U.K. university student population.","volume":"82","author":"NS Logan","year":"2005","journal-title":"Optometry and vision science: official publication of the American Academy of Optometry"},{"issue":"15","key":"pone.0260993.ref038","first-page":"1","article-title":"Myopia:a review of its etiology, pathogenesis and treatment","author":"BJ Curtin","year":"1970","journal-title":"Survey of ophthalmology"},{"issue":"5","key":"pone.0260993.ref039","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/S0039-6257(03)00086-9","article-title":"Epidemiology of refractive errors and presbyopia.","volume":"48","author":"RA Weale","year":"2003","journal-title":"Surv Ophthalmol."},{"key":"pone.0260993.ref040","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.preteyeres.2017.09.004","article-title":"The epidemics of myopia: Aetiology and prevention","volume":"62","author":"IG Morgan","year":"2018","journal-title":"Progress in retinal and eye research"},{"issue":"1","key":"pone.0260993.ref041","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1186\/s12967-019-2057-2","article-title":"Discrimination of indoor versus outdoor environmental state with machine learning algorithms in myopia observational studies","volume":"17","author":"B Ye","year":"2019","journal-title":"Journal of translational medicine"},{"key":"pone.0260993.ref042","doi-asserted-by":"crossref","first-page":"k2022","DOI":"10.1136\/bmj.k2022","article-title":"Education and myopia: assessing the direction of causality by mendelian randomisation","volume":"361","author":"E Mountjoy","year":"2018","journal-title":"BMJ (Clinical research ed)."},{"issue":"1","key":"pone.0260993.ref043","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1002\/gepi.21936","article-title":"Assessing the Genetic Predisposition of Education on Myopia: A Mendelian Randomization Study","volume":"40","author":"G Cuellar-Partida","year":"2016","journal-title":"Genetic epidemiology"},{"issue":"5","key":"pone.0260993.ref044","doi-asserted-by":"crossref","first-page":"e0154554","DOI":"10.1371\/journal.pone.0154554","article-title":"Education-Related Parameters in High Myopia: Adults versus School Children.","volume":"11","author":"JB Jonas","year":"2016","journal-title":"PloS one."},{"issue":"4","key":"pone.0260993.ref045","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1136\/adc.63.4.356","article-title":"Preschool vision screening: a service in need of rationalisation","volume":"63","author":"SL Stewart-Brown","year":"1988","journal-title":"Archives of disease in childhood"},{"key":"pone.0260993.ref046","doi-asserted-by":"crossref","first-page":"46104","DOI":"10.1038\/srep46104","article-title":"Daily touchscreen use in infants and toddlers is associated with reduced sleep and delayed sleep onset.","volume":"7","author":"CH Cheung","year":"2017","journal-title":"Scientific reports."},{"issue":"5","key":"pone.0260993.ref047","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1111\/josh.12502","article-title":"The Association of Physical Activity and Academic Behavior: A Systematic Review.","volume":"87","author":"RA Sullivan","year":"2017","journal-title":"The Journal of school health"},{"key":"pone.0260993.ref048","unstructured":"Sporting Future (Second annual report) 2018 [Available from: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/677557\/2018_Second_annual_report_to_parliament_on_Sporting_Future.pdf."},{"key":"pone.0260993.ref049","unstructured":"Childhood Obesity: a plan for action 2018 [Available from: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/718903\/childhood-obesity-a-plan-for-action-chapter-2.pdf."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0260993","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T00:28:43Z","timestamp":1700094523000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0260993"}},"subtitle":[],"editor":[{"given":"Der-Chong","family":"Tsai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,1,19]]},"references-count":49,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1,19]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0260993","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,19]]}}}