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Generational difference of refractive error in the baseline study of the Beijing Myopia Progression Study
  1. Yuan Bo Liang1,2,3,
  2. Zhong Lin1,3,
  3. Balamurali Vasudevan5,
  4. Vishal Jhanji3,
  5. Alvin Young4,
  6. Tie Ying Gao6,3,
  7. Shi Song Rong3,
  8. Ning Li Wang1,
  9. Kenneth J Ciuffreda7
  1. 1Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
  2. 2The Affiliated Eye Hospital and School of Optometry and Ophthalmology, Wenzhou Medical College, Wenzhou, Zhejiang, China
  3. 3Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
  4. 4Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
  5. 5College of Optometry, Mid Western University, Glendale, Arizona, USA
  6. 6Handan Eye Hospital, Handan, Hebei, China
  7. 7Department of Biological and Vision Sciences, SUNY College of Optometry, New York, New York, USA
  1. Correspondence to Dr Yuan Bo Liang, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab. No. 1 Dong Jiao Min Xiang Street, Dongcheng District, Beijing, People's Republic of China, 100730; yuanboliang{at}


Aims To report the refractive error difference (RED) between parents and their children and the estimated single generational myopic shift in an urban area in China.

Methods 395 children aged 6–17 years and their parents, who had been enrolled in the Beijing Myopia Progression Study were included. Cycloplegic and non-cycloplegic refraction of the children and parents were performed, respectively. RED was defined as the difference between the average parental spherical equivalent (SE) and the average SE of their children. Binomial fitted curves of RED were plotted as a function of the children's age. Generational myopic shift was defined as the estimated RED according to the prediction model at the age of 18 years.

Results 395 families were enrolled. The RED was positively correlated with the children's age (rspearman=0.58, p<0.001). The RED (median (25th and 75th percentile)) was −1.88 (−3.23 to −1.00) dioptres (D) in children at 6.0–7.9 years of age, and it increased to 1.53 (−0.12 to 3.44) D in children at 16.0–17.9 years of age. The SE of the children approached the average SE of their parents at the age of 11 years. At the age of 18 years, the children's estimated myopic shift would be 1.94 D.

Conclusions In this sample, children's refractive errors at the age of 11 years were already similar to their parents. Moreover, the estimated myopia in children at the age of 18 years would be up to 2.0 D higher than their parents. This remarkable single-generation myopic shift indicates that there are likely effects of environmental factors on myopia development in urban Chinese children.

  • Optics and Refraction

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