Myopia in Schoolchildren Predicted by Novel Nomogram

Reading at the library
Portrait of an Asian girl in a pink dress wearing eye glasses reading while standing in front of an isle of books at the library.
Early prediction of myopia can identify children most at risk and allow for timely interventions.

Researchers have created a nomogram that predicts individual myopia onset in schoolchildren, according to research published in the American Journal of Ophthalmology. 

Investigators enrolled 1073 schoolchildren (mean age 7.8±0.7 years, 53.1% boys) in the 2-center, prospective follow-up analysis. The team recorded a total of 21 baseline variables in the nomogram prediction model. They performed non-cycloplegic refractions and administered a questionnaire to determine time spent performing near work, time spent outdoors, parental education levels, and the existence of parental myopia. Researchers validated the nomogram through area under the receiver operating characteristic curves (AUC), calibration plot, decision curve analysis, and Kaplan-Meier curves. 

The team determined that 5 of the 21 variables recorded at baseline best predicted myopia: female sex (HR=1.94), axial length (AL), spherical equivalent refraction (SER), corneal refractive power (CR), and positive relative accommodation (PRA). These findings confirmed that ophthalmological factors predicted myopia better than genetic or environmental factors. Among the 5 baseline variables used in the nomogram, SER demonstrated the best predictive performance, but single SER did not predict future myopia well in schoolchildren who were Chinese (AUC=0.66).  

“Although vision can be corrected with spectacles, contact lenses, or surgery, the underlying defect of myopia, which means a slightly elongated eyeball, cannot be addressed and it may increase the risk of eye diseases and even blindness,” according to the researchers. “Therefore, accurate prediction of myopia onset in schoolchildren is crucial since it can effectively identify high-risk schoolchildren and implement timely targeted interventions.”

Study limitations include potential geographical bias, reliance on self-reporting for some study data, and the use of non cycloplegic refraction. 

Disclosure: This research was supported by Wenzhou Medical University-Essilor International Research Center. One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 


Guo C, Ye Y, Yuan Y, et al. Development and validation of a novel nomogram for predicting the occurrence of myopia in schoolchildren: a prospective cohort study. Am J Ophthalmol. doi:10.1016/j.ajo.2022.05.027