Pseudomyopia May Increase Myopia Onset Risk in Children

Pediatric patients with pseudomyopia are more likely to develop myopia compared with children who do not have pseudomyopia, according to research published in the British Journal of Ophthalmology.

Researchers conducted a population-based, prospective cohort study to investigate whether pseudomyopia (spherical equivalent [SE] ≤-0.50 diopters (D) before cycloplegia and >-0.50D after cycloplegia) is an independent risk factor for myopia onset. The team included 2328 children without myopia (baseline age, 4-17 years) who underwent biomicroscopic and uncorrected distance visual acuity measurements at baseline and 6 months. Children who were older than 7 years also underwent accommodative function assessment.

During the 6-month follow-up period, 21.1% of eyes with pseudomyopia developed myopia compared with 3.8% of eyes without the condition. Pseudomyopia was an independent risk factor for developing myopia (relative risk [RR], 2.52; 95% CI, 1.86-3.42), the report shows. Stratified according to age, children aged 8 to 10 years with pseudomyopia had a 3.33 times risk of developing myopia (95%CI, 2.13-5.23; P <.001), which increased to a 4.07 times risk in children aged 11 to 13 years (95% CI, 1.85-8.94; P <.001).

Among participants with pseudomyopia, more cycloplegic SE, a smaller difference between cycloplegic and non cycloplegic SE, and higher binocular amplitude of accommodation exacerbated myopia development risk (P <.001 for all). 

“Despite the fact that we identify pseudomyopia as an independent risk factor for myopia onset, clinicians should envisage that the children, once they are in premyopia status, are at significantly increased risk of developing myopia, and thus all prophylactic measures should be adopted, for example, outdoor time intervention,” the study authors suggest.

Study limitations include a short follow-up period, potential overestimation of the accommodative amplitude with the push-up test, potential recall bias for reporting outdoor activity and near work times, and the inclusion of children from only 1 geographic province.