Article Text

Download PDFPDF
Ethnicity-specific prevalences of refractive errors vary in Asian children in neighbouring Malaysia and Singapore
  1. S-M Saw1,
  2. P-P Goh3,
  3. A Cheng2,
  4. A Shankar1,
  5. D T H Tan2,
  6. L B Ellwein4
  1. 1Department of Community, Occupational and Family Medicine, National University of Singapore, Singapore
  2. 2Singapore Eye Research Institute, Singapore
  3. 3Department of Ophthalmology, Hospital Selayang, Selangor, Malaysia
  4. 4National Eye Institute, National Institutes of Health, Bethesda, Maryland, USA
  1. Correspondence to: S-M Saw Department of Community, Occupational and Family Medicine, National University of Singapore, 16 Medical Drive, Singapore 117597, Singapore;cofsawsm{at}


Aim: To compare the prevalences of refractive errors in Malay, Chinese and Indian children in Malaysia and Singapore.

Methods: Children aged 7–9 years from three schools in the Singapore Cohort study of the Risk factors for Myopia (n = 1962) and similarly aged children from a random cluster sample in the metropolitan Kuala Lumpur area in the Malaysia Refractive Error Study in Children (n = 1752) were compared. Cycloplegic autorefraction was conducted in both countries.

Results: The prevalence of myopia (spherical equivalent of at least −0.5 diopters (D) in either eye) was higher in Singapore Malays (22.1%) than in Malays in Malaysia (9.2%; 95% confidence interval (CI) 11.2 to 14.7; p<0.001). Similarly, Singapore Chinese (40.1%) had higher prevalences than Malaysian Chinese (30.9%; 95% CI 1.5 to 16.9). Singapore Indians had a higher prevalence (34.1%) than Malaysian Indians (12.5%; 95% CI 17.4 to 25.9). The multivariate odds ratio of astigmatism (cylinder at least 0.75 D in either eye) in Singapore Malays compared with Malaysian Malays was 3.47 (95% CI 2.79 to 4.32). Ethnicity-specific hyperopia rates did not differ in Singapore and Malaysia.

Conclusion: The ethnicity-specific prevalences of myopia in Singapore Malays, Chinese and Indians are higher than those in Malaysian Malays, Chinese and Indians. As Malays, Chinese and Indians in Malaysia have genetic make-up similar to that of Malays, Chinese and Indians in Singapore, environmental factors may contribute to the higher myopia rates.

  • RESC, Refractive Error Study in Children
  • SCORM, Singapore COhort study of the Risk factors for Myopia

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Published Online First 29 June 2006

  • Funding: This study was supported by the National Medical Research Council (NMRC), NMRC/0975/2005, Singapore; the World Health Organization under National Institutes of Health contract N01-EY-2103; and the Ministry of Health Malaysia under Major Research Grant 2003/13.

  • Competing interests: None.

Linked Articles

  • BJO at a glance
    Creig Hoyt