Spotlight on Myopia in Europe

Europe is the second smallest continent, comprising around 50 countries and approximately 740 million inhabitants. It stretches from the Atlantic Ocean in the west to the Arctic Ocean in the north and the Mediterranean Sea in the south, and is marked by significant cultural and linguistic diversity. We invited Prof. Cristina Álvarez Peregrina and Dr. Miguel‑Ángel Sánchez‑Tena from Madrid, leading experts in myopia research and authors of "Analysing myopia in Europe: A comprehensive meta-analysis" published in Graefe's Archive for Clinical and Experimental Ophthalmology in 2026, to discuss the current situation of myopia in Europe.

Miguel-Ángel: Myopia is a major public health issue, especially in Asia, but in Europe the data are fragmented and sometimes inconsistent. We wanted to provide clinicians with a clearer overview of myopia prevalence in Europe, looking not only at overall rates but also at differences by age, region, and gender. In some countries, such as Spain, cycloplegia is not routinely used, which complicates comparisons with countries where cycloplegic refraction is standard. Our goal was to bring these data together and organize them in a way that allows more robust conclusions about myopia prevalence in Europe.

Cristina: We have been studying myopia prevalence in Spanish children since 2016. At some point, we started to wonder whether what we were seeing in Spain reflected the situation in other European countries. This led us to conduct a European meta-analysis to place our Spanish data in a broader context.

Cristina: We found that about one in four Europeans has myopia, which is very similar to earlier estimates from Holden and colleagues. So myopia is clearly a European problem, not just an Asian one. We did not observe relevant differences between males and females or between rural and urban areas, although rural data were limited. Studies using cycloplegia reported lower prevalence than those without it, which is important to bear in mind when comparing studies over time and between countries. Regional differences within Europe were small and likely reflect methodological heterogeneity rather than true lifestyle differences.

Miguel-Ángel: In numbers, myopia prevalence is about 25% and high myopia about 3%. Prevalence increases with age: roughly 3% to 9% in younger children, 15% to 25% in school‑age children, and about 33% to 35% in adults. That is why we always say: each age group matters.

Cristina: Many still see myopia as mainly an Asian problem. Parents often realize their children see poorly but are not aware that myopia increases the risk of future eye diseases. We need stronger public health policies and clearer communication with health authorities, educators, and policymakers so they understand the scale of the problem. High myopia is still relatively rare, so it may not feel urgent yet—but if overall myopia continues to rise, the burden of high myopia will inevitably grow. We should act now, not wait.

Cristina: In children aged about 5 to 7 years, prevalence increased from 2016 until the start of the COVID‑pandemic. After COVID, this upward trend seemed to stop. Spain had very strict lockdowns; children could not go outside for about 12 weeks. Afterwards, many parents consciously increased their children’s outdoor time, which we believe helped stabilize prevalence. Since 2020, prevalence in this age group has remained at around 20% in our data. In contrast, in other European regions, prevalence has continued to rise, probably because restrictions were less strict and there was less change in outdoor habits afterwards.

Miguel-Ángel: The economic burden becomes substantial with high myopia, which increases the risk of serious retinal complications and other conditions that require complex and expensive treatments. This affects not only patients but also healthcare systems and society. That is why early detection and efforts to slow progression are so important: they can help prevent progression to high myopia and reduce long‑term costs.

Cristina: We will continue our work in Spain and are also involved in the European Myopia Network. Together with colleagues from several countries, we are working on projects to better understand myopia across Europe. The network has committees focused on communication, education, science, and sponsorship. Our aim is to harmonize how we communicate and how we measure and manage myopia in Europe.

Cristina: Awareness. Many people in Europe still underestimate the scale of the myopia problem. We need to act now – especially in schools and at the governmental level – while there is still an opportunity to prevent a much larger future burden. Our meta‑analysis also highlights large methodological variability between the 28 studies we included. More standardized methods are essential if we want to make precise comparisons between regions and between Europe and Asia. Until then, we must interpret existing data carefully and always consider how the studies were conducted.