Article Text

Download PDFPDF
Refractive error, axial length and anterior chamber depth of the eye in British adults: the EPIC-Norfolk Eye Study
  1. P J Foster1,2,
  2. D C Broadway3,
  3. S Hayat4,
  4. R Luben4,
  5. N Dalzell4,
  6. S Bingham5,
  7. N J Wareham4,
  8. K-T Khaw4
  1. 1Division of Genetics & Epidemiology, UCL Institute of Ophthalmology, University College London, UK
  2. 2National Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, London, UK
  3. 3Department of Ophthalmology, Norfolk and Norwich University Hospital, Norwich, UK
  4. 4Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK
  5. 5MRC Dunn Human Nutrition Unit, Cambridge University, Cambridge, UK
  1. Correspondence to Paul J Foster, Division of Genetics and Epidemiology, UCL Institute of Ophthalmology, 11-43 Bath Street, London EC1V 9EL, UK; p.foster{at}


Purpose To describe the distribution, and demographic and socioeconomic correlates of refractive error and related ocular biometry in an older British population.

Methods Refractive error was measured using an auto-refractor without cycloplegia. Pseudophakic individuals and those who had undergone refractive surgery were excluded from analysis. Axial length and anterior chamber depth were measured using partial coherence laser interferometry. Occupation category and highest educational achievement were recorded.

Results Biometric data were available for 2519 people (1090 men, 1429 women; 93.2% of all participants) aged 48 to 88 years. Refractive data were available for both eyes in 2210 bilaterally phakic participants. Among phakic individuals, axial length of the eye was strongly inversely correlated with refractive error in both men and women (p<0.001). Axial length of the eye was strongly, independently related to height, weight and social class, but most strongly related to educational achievement. In contrast, anterior chamber depth varied with age and sex, but not with socioeconomic status. There was a significant inverse association between anterior chamber depth and refraction in women (p<0.001) but not in men (p=0.495).

Conclusion Refractive error in this predominantly white older UK population was associated with axial biometry and sociodemographic characteristics. Educational status was the strongest determinant of axial length.

  • Anterior chamber
  • optics and refraction
  • epidemiology
  • anatomy

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.


  • Funding Medical Research Council (London); Research into Ageing (London); The Richard Desmond Charitable Trust (via Fight for Sight, London); the NIHR BMRC UK (MEH & UCL-IOO).

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the East Norfolk and Waveney NHS Research Governance Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Linked Articles

  • At a glance
    Harminder S Dua Arun D Singh