IMI—Onset and Progression of Myopia in Young Adults

Myopia typically starts and progresses during childhood, but onset and progression can
occur during adulthood. The goals of this review are to summarize published data on
myopia onset and progression in young adults, aged 18 to 40 years, to characterize
myopia in this age group, to assess what is currently known, and to highlight the gaps
in the current understanding. Specifically, the peer-reviewed literature was reviewed
to: characterize the timeline and age of stabilization of juvenile-onset myopia; estimate
the frequency of adult-onset myopia; evaluate the rate of myopia progression in adults,
regardless of age of onset, both during the college years and later; describe the rate of
axial elongation in myopic adults; identify risk factors for adult onset and progression;
report myopia progression and axial elongation in adults who have undergone refractive
surgery; and discuss myopia management and research study design. Adult-onset myopia
is common, representing a third or more of all myopia in western populations, but less in
East Asia, where onset during childhood is high. Clinically meaningful myopia progres-
sion continues in early adulthood and may average 1.00 diopters (D) between 20 and
30 years. Higher levels of myopia are associated with greater absolute risk of myopia-
related ocular disease and visual impairment, and thus myopia in this age group requires
ongoing management. Modalities established for myopia control in children would be
options for adults, but it is difficult to predict their efficacy. The feasibility of studies of
myopia control in adults is limited by the long duration required