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Susan Vitale, PhD, MHS; Leon Ellwein, PhD; Mary Frances Cotch, PhD; Frederick L. Ferris III, MD; Robert Sperduto, MD

Arch Ophthalmol. 2008;126(8):1111-1119.

Objective  To describe the prevalence of refractive error in the United States.

Methods  The 1999-2004 National Health and Nutrition Examination Survey (NHANES) used an autorefractor to obtain refractive error data on a nationally representative sample of the US noninstitutionalized, civilian population 12 years and older. Using data from the eye with a greater absolute spherical equivalent (SphEq) value, we defined clinically important refractive error as follows: hyperopia, SphEq value of 3.0 diopters (D) or greater; myopia, SphEq value of –1.0 D or less; and astigmatism, cylinder of 1.0 D or greater in either eye.

Results  Of 14 213 participants 20 years or older who completed the NHANES, refractive error data were obtained for 12 010 (84.5%). The age-standardized prevalences of hyperopia, myopia, and astigmatism were 3.6% (95% confidence interval [CI], 3.2%-4.0%), 33.1% (95% CI, 31.5%-34.7%), and 36.2% (95% CI, 34.9%-37.5%), respectively. Myopia was more prevalent in women (39.9%) than in men (32.6%) (P < .001) among 20- to 39-year-old participants. Persons 60 years or older were less likely to have myopia and more likely to have hyperopia and/or astigmatism than younger persons. Myopia was more common in non-Hispanic whites (35.2%) than in non-Hispanic blacks (28.6%) or Mexican Americans (25.1%) (P < .001 for both).

Conclusion  Estimates based on the 1999-2004 NHANES vision examination data indicate that clinically important refractive error affects half of the US population 20 years or older.

Author Affiliations: Division of Epidemiology and Clinical Research, National Eye Institute, National Institutes of Health (Drs Vitale, Cotch, Ferris, and Sperduto), and National Eye Institute, National Institutes of Health (Dr Ellwein), Bethesda, Maryland.

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