Clinically Meaningful Myopia Progression May Persist in Some Adults

A small proportion individuals continue to experience significant myopia progression into adulthood.

Clinically meaningful myopia progression is uncommon among individuals aged 21 years or older, but it can occur within a small proportion of adults with myopia, according to a study published in Optometry and Vision Science. Consistent exposure to an academic environment may elevate the risk of myopia progression in this population, according to the report.

Researchers included 354 adults with myopia (mean age, 22 years; 64.7% women) in the retrospective investigation to determine the presence of clinically meaningful myopia progression and associated risk factors. Study participants, who presented to a single center, underwent non cycloplegic refractive error measurements, and the team determined annual myopia progression using differences in spherical equivalent (SE) between the initial and subsequent visits. The analysis considered patient demographics, learning environment, refractive error and keratometry. The researchers determined myopia progression from the SE changes between visits (mean follow up, 2.7 years). 

[T]here are a small proportion of adult myopes who continue to progress at a clinically meaningful level.

Stratified according to age, the report shows that the mean annual progression was −0.10 diopters (D), −0.80 D and −0.04 D among individuals aged 18 to 21 years, participants aged 22 to 26 years, and patients aged 27 to 30 years, respectively (P=.003). These values were significantly different when compared between individuals aged 18 to 21 years and participants aged 27 to 30 years (P =.05).

The portion of progressors was highest among participants aged 18 to 21 years (18.3%), followed by patients aged 22 to 26 years (10.9%), and individuals aged 27 to 30 years (8.8%). A total of 16.2% of participants worked or studied in an academic environment, and these individuals were twice as likely to demonstrate myopia progression compared with individuals who did not work or study in an academic environment (odds ratio [OR], 2.07; 95% CI, 1.15-3.3.74; P =.02).

“On average, myopia does not progress by substantial amounts throughout the adult years, particularly after the age of 21 years,” according to the study authors.

However, the team emphasizes that “there are a small proportion of adult myopes who continue to progress at a clinically meaningful level.”

The study’s retrospective design, limited sample size, the use of non cycloplegic refraction, and variations in the visit intervals are acknowledged limitations to the research.


Khan HA, Naduvilath T, Tahhan N, Sankaridurg P. Myopia progression in adults: a retrospective analysis. Optom Vis Sci. Published online August 1, 2023. doi:10.1097/OPX.0000000000002045