title: Frequency and Distribution of Refractive Error in Adult Life: Methodology and Findings of the UK Biobank Study.
abstract: OBJECTIVE
  To report the methodology and findings of a large scale investigation of burden and distribution of refractive error, from a contemporary and ethnically diverse study of health and disease in adults, in the UK.
  
  
  METHODS
  U K Biobank, a unique contemporary resource for the study of health and disease, recruited more than half a million people aged 40-69 years. A subsample of 107,452 subjects undertook an enhanced ophthalmic examination which provided autorefraction data (a measure of refractive error). Refractive error status was categorised using the mean spherical equivalent refraction measure. Information on socio-demographic factors (age, gender, ethnicity, educational qualifications and accommodation tenure) was reported at the time of recruitment by questionnaire and face-to-face interview.
  
  
  RESULTS
  Fifty four percent of participants aged 40-69 years had refractive error. Specifically 27% had myopia (4% high myopia), which was more common amongst younger people, those of higher socio-economic status, higher educational attainment, or of White or Chinese ethnicity. The frequency of hypermetropia increased with age (7% at 40-44 years increasing to 46% at 65-69 years), was higher in women and its severity was associated with ethnicity (moderate or high hypermetropia at least 30% less likely in non-White ethnic groups compared to White).
  
  
  CONCLUSIONS
  Refractive error is a significant public health issue for the UK and this study provides contemporary data on adults for planning services, health economic modelling and monitoring of secular trends. Further investigation of risk factors is necessary to inform strategies for prevention. There is scope to do this through the planned longitudinal extension of the UK Biobank study.
authors.affiliation: Life Course Epidemiology and Biostatistics Section, University College London (UCL) Institute of Child Health, London, United Kingdom; Ulverscroft Vision Research Group, UCL Institute of Child Health, London, United Kingdom.
authors.forename: Phillippa M
authors.initials: PM
authors.lastname: Cumberland
authors.affiliation: Life Course Epidemiology and Biostatistics Section, University College London (UCL) Institute of Child Health, London, United Kingdom; Ulverscroft Vision Research Group, UCL Institute of Child Health, London, United Kingdom.
authors.forename: Yanchun
authors.initials: Y
authors.lastname: Bao
authors.affiliation: Department of Ophthalmology, King's College London, St Thomas' Hospital Campus, London, United Kingdom.
authors.forename: Pirro G
authors.initials: PG
authors.lastname: Hysi
authors.affiliation: National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Foster
authors.affiliation: Department of Ophthalmology, King's College London, St Thomas' Hospital Campus, London, United Kingdom; Department of Twin Research and Genetic Epidemiology, King's College London, St Thomas' Hospital Campus, London, United Kingdom.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Hammond
authors.affiliation: Life Course Epidemiology and Biostatistics Section, University College London (UCL) Institute of Child Health, London, United Kingdom; Ulverscroft Vision Research Group, UCL Institute of Child Health, London, United Kingdom; National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom; Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.
authors.forename: Jugnoo S
authors.initials: JS
authors.lastname: Rahi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012030:Refractive Errors / Q000453:epidemiology*; D006113:United Kingdom / Q000453:epidemiology