Epidemiology of Refractive Errors in an Adult European Population: The Segovia Study

Purpose: To determine the prevalence of refractive errors in Segovia, Spain. Methods: A cohort of 569 subjects was randomly selected in a stratified manner according to gender and age in a cross-sectional, population-based epidemiologic study, the target population of which was urban residents aged 40 to 79 years. All participants underwent an ophthalmic examination that included measurement of visual acuity (VA) and refraction, tonometry, anterior segment biomicroscopy, funduscopy, optic nerve head photography, and visual field testing. Of those, 417 subjects were enrolled who met the inclusion criteria of a phakic right eye and VA over 20/40. The prevalence of spherical errors was assessed after calculating the spherical equivalent and defining myopia as -0.5 diopters; (D) or less and hyperopia as +0.50 D or more. The prevalence of astigmatism over 0.50 D was evaluated In minus cylinder form. Results: The estimated prevalences (95% confidence interval) of myopia,,hyperopia, and astigmatism, in the population were 25.4% (21.5-29.8%) 43.6% (39-48.4%), and 53.5% (48.7-58.2%), respectively. No significant gender difference was found in the prevalence of any refractive errors. The prevalence of myopia or the mean value did not change significantly with age. The mean hyperopia and the mean astigmatism (p < 0.01 for both) and the prevalence increased with increasing age (p < 0.01 for both). Anisometropia of 1 D or more was present in 12.3% (49/396 subjects). Conclusion: More than 60% of the Segovia population over 40 years of age has a refractive error, with 25.4% myopic and 43.6% hyperopic. Astigmatism is present in over half of the population and the types change with age.