PURPOSE To describe the prevalence of refractive errors in a population of adult Americans.
METHODS From 1988 to 1990, 4926 adults who were 43 to 84 years of age and living in Beaver Dam, Wisconsin at the time of the 1987-1988 census were examined. Refractions were performed according to a modification of the Early Treatment Diabetic Retinopathy Study protocol. Included in this study were 4533 people who had not undergone cataract surgery and who had a best corrected visual acuity better than 20/40 in at least one eye. Myopia was defined as a refractive error less than -0.50 diopters; hyperopia was defined as a refractive error greater than +0.50 diopters.
RESULTS Hyperopia was more frequent than myopia in the study group (age-adjusted of 49.0% and 26.2% in right eyes, respectively, P = 0.0001). The prevalence of hyperopia in the right eye increased with increasing age from 22.1% in those 43 to 54 years of age to 68.5% in those 75 years of age or older. The prevalence of myopia in the right eye decreased from 43.0% in those 43 to 54 years of age to 14.4% in those 75 years of age or older. There was significant relationship between education level and refractive error (age adjusted r = -0.32, P = 0.0001). Neither household income nor occupation was associated with refractive error in our data.
CONCLUSION These cross-sectional data indicate age-related differences in refractive status in an adult population and suggest that education is associated with myopia independent of age.