Refractive Error of the Elderly Presenting to a University Eye Clinic


  • Matee Jaradaroonchay Faculty of Optometry, Rangsit University, Pathum Thani 12000, Thailand
  • Ploychompoo Parsuraphun Faculty of Optometry, Rangsit University, Pathum Thani 12000, Thailand
  • Jerry Vincent Faculty of Optometry, Rangsit University, Pathum Thani 12000, Thailand
  • Watanee Jenchitr Faculty of Optometry, Rangsit University, Pathum Thani 12000, Thailand & RSU Healthcare, Sukhumvit 31, Bangkok 10110, Thailand



refractive errors, anisometropia, elderly, university eye clinic, myopic macular degeneration


The prevalence of refractive errors varies by age and gender and is closely related to functional difficulties, ocular diseases, and decreased quality of life. The purpose of this study was to assess associations of age and gender with refractive errors of the elderly presenting at a university clinic. Retrospective review of medical records of elderly patients presenting for eye services in 2020-2021. Demographic, ocular disease and refractive data were collected and analyzed. The number of 1,452 patients aged 60 and over with a mean age of 69.6 ± 8.09 years (range 60 to 101 years) were included. The prevalence of myopia, hyperopia, astigmatism, and anisometropia was 22.4%, 36.5%, 22.7%, and 19.4%, respectively. Compared to those aged 80 and above, myopia increased 5.171 times in those 60-69 yrs and 4.930 times among those 70-79 yrs. Men were significantly more likely to have myopia than women (p<0.001). Hyperopia was significantly less prevalent in those aged 70-79 and aged 80 and above compared to those aged 60-69 (p<0.001). Gender was not associated with hyperopia (p=0.066). The prevalence of astigmatism and anisometropia was higher in older subjects. Astigmatism shifted from with-the-rule (WTR) to against-the-rule (ATR) with age. Astigmatism had no gender difference, but anisometropia was more common in women. Most anisometropia was due to refractive error. Rates of myopia and hyperopia decreased with age while astigmatism increased with age. Thai optometrists need to be aware that refractive error in the elderly is not stationary and frequent changes in spectacle power may be needed.


Asano, K., Nomura, H., Iwano, M., Ando, F., Niino, N., Shimokata, H., Miyake, Y. (2005). Relationship between astigmatism and aging in middle-aged and elderly Japanese. Japanese Journal of Ophthalmology, 49(2), 127–33.

Fricke, T. R., Holden, B. A., Wilson, D. A., Schlenther, G., Naidoo, K. S., Resnikoff, S., & Frick, K. D. (2012). Global cost of correcting vision impairment from uncorrected refractive error. Bulletin of the World Health Organization, 90, 728-738.

Gudmundsdottir, E., Jonasson, F., Jonsson, V., Stefánsson, E., Sasaki, H., Sasaki, K., & Iceland‐Japan Co‐Working Study Groups. (2000). “With the rule” astigmatism is not the rule in the elderly: Reykjavik Eye Study: a population based study of refraction and visual acuity in citizens of Reykjavik 50 years and older. Acta Ophthalmologica Scandinavica, 78(6), 642-646.

Gupta, A., Casson, R. J., Newland, H. S., Muecke, J., Landers, J., Selva, D., & Aung, T. (2008). Prevalence of refractive error in rural Myanmar: the Meiktila Eye Study. Ophthalmology, 115(1), 26-32.

Haegerstrom-Portnoy, G., Schneck, M. E., Lott, L. A., Hewlett, S. E., & Brabyn, J. A. (2014). Longitudinal increase in anisometropia in older adults. Optometry and Vision Science, 91(1), 60-67.

Hashemi, A., Khabazkhoob, M., & Hashemi, H. (2023). High prevalence of refractive errors in an elderly population; a public health issue. BMC Ophthalmology, 23(1), 38.

Hashemi, H., KhabazKhoob, M., Miraftab, M., Mohammad, K., & Fotouhi, A. (2011). The association between refractive errors and cataract: The Tehran eye study. Middle East African Journal of Ophthalmology, 18(2), 154-158.

Holden, B. A., Fricke, T. R., Wilson, D. A., Jong, M., Naidoo, K. S., Sankaridurg, P., ... & Resnikoff, S. (2016). Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology, 123(5), 1036-1042.

Jenchitr, W., & Jaradaroonchay, M. (2022). Epidemiology of refractive error. Public Health Ophthalmology and Optometry, 2022, 251-262.

Jenchitr, W., & Raiyawa, S. (2012). Refractive errors: the major visual impairment in Thailand [NB]. Journal of Current Science and Technology, 2(2), 133-141.

Jenchitr, W., Hanutsaha, P., Iamsirithaworn, S., Parnrat, U., Choosri, P., & Yenjitr, C. (2007). Thailand national survey of visual impairment in 2006-7. The Thai Journal of Ophthalmology, 21(1), 10-85.

Jenchitr, W., Yokkampon, P., Ploysit, P., & Ausayakhun, S. (2024).The Prevalence of Visual Impairment of the Elderly at University Eye Clinic. Journal of Current Science and Technology,14(1), Article 9.

Khoramnia, R., Auffarth, G., Łabuz, G., Pettit, G., & Suryakumar, R. (2022). Refractive outcomes after cataract surgery. Diagnostics, 12(2), Article 243.

Lundström, M., Dickman, M., Henry, Y., Manning, S., Rosen, P., Tassignon, M. J., ... & Stenevi, U. (2018). Risk factors for refractive error after cataract surgery: analysis of 282 811 cataract extractions reported to the European Registry of Quality Outcomes for cataract and refractive surgery. Journal of Cataract & Refractive Surgery, 44(4), 447-452.

Naidoo, K. S., Fricke, T. R., Frick, K. D., Jong, M., Naduvilath, T. J., Resnikoff, S., & Sankaridurg, P. (2019). Potential lost productivity resulting from the global burden of myopia: systematic review, meta-analysis, and modeling. Ophthalmology, 126(3), 338-346.

Nakamura, Y., Nakamura, Y., Higa, A., Sawaguchi, S., Tomidokoro, A., Iwase, A., & Araie, M. (2018). Refractive errors in an elderly rural Japanese population: the Kumejima study. PLoS One, 13(11), Article e0207180.

Namba, H., Sugano, A., Murakami, T., Utsunomiya, H., Nishitsuka, K., Ishizawa, K., ... & Yamashita, H. (2020). Age-related changes in astigmatism and potential causes. Cornea, 39, S34-S38.

Pezzullo, L., Streatfeild, J., Simkiss, P., & Shickle, D. (2018). The economic impact of sight loss and blindness in the UK adult population. BMC health services research, 18, 1-13.

Sheeladevi, S., Seelam, B., Nukella, P. B., Borah, R. R., Ali, R., & Keay, L. (2019). Prevalence of refractive errors, uncorrected refractive error, and presbyopia in adults in India: A systematic review. Indian Journal of Ophthalmology, 67(5), 583-592.

Sherwin, J. C., Khawaja, A. P., Broadway, D., Luben, R., Hayat, S., Dalzell, N., ... & Foster, P. J. (2012). Uncorrected refractive error in older British adults: the EPIC-Norfolk Eye Study. British Journal of Ophthalmology, 96(7), 991-996.

Smith, T. S. T., Frick, K. D., Holden, B. A., Fricke, T. R., & Naidoo, K. S. (2009). Potential lost productivity resulting from the global burden of uncorrected refractive error. Bulletin of the World Health Organization, 87(6), 431-437.

Steinmetz, J. D., Bourne, R. R., Briant, P. S., Flaxman, S. R., Taylor, H. R., Jonas, J. B., ... & Morse, A. R. F. (2021). Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study. The Lancet Global Health, 9(2), e144-e160.

Tan, C. S. H., Chan, Y. H., Wong, T. Y., Gazzard, G., Niti, M., Ng, T. P., & Saw, S. M. (2011). Prevalence and risk factors for refractive errors and ocular biometry parameters in an elderly Asian population: the Singapore Longitudinal Aging Study (SLAS). Eye, 25(10), 1294-1301.

Vitale, S., Sperduto, R. D., & Ferris, F. L. (2009). Increased prevalence of myopia in the United States between 1971-1972 and 1999-2004. Archives of Ophthalmology, 127(12), 1632-1639.




How to Cite

Jaradaroonchay, M., Parsuraphun, P., Vincent, J., & Jenchitr, W. (2024). Refractive Error of the Elderly Presenting to a University Eye Clinic. Journal of Current Science and Technology, 14(2).



Research Article