Progression of myopia among undergraduate students of Fatima Jinnah Medical University, Lahore

Abstract

Background and Objective: The global rise in myopia has become a significant public health concern, with a projected prevalence affecting nearly half of the world’s population by 2050. Despite increasing prevalence in low- and middle-income countries (LMICs), longitudinal data on myopia progression, especially in high-risk academic cohorts, remain limited. This study investigates the five-year progression of myopia and its behavioral correlates among undergraduate female medical students in Pakistan.

Methodology: A longitudinal prospective study was conducted at Fatima Jinnah Medical University, Lahore, including 304 students enrolled in the 2020 MBBS batch. Annual measurements of spherical equivalent refraction (SER), self-reported screen time, and study time were collected over five academic years, from January 2020 to December 2025. Descriptive statistics summarized SER progression and behavioral exposure. Linear mixed-effects models (LMM) assessed SER changes across time. Multivariable linear regression evaluated predictors of SER progression (ΔSER). Spearman’s correlation and subgroup analyses examined associations with behavioral and demographic variables.

Results: Of the 304 students, 48 had complete longitudinal SER data. The mean SER progressed from –1.66 D (SD ±2.41) at baseline to –2.73 D (SD ±1.78) after five years, with a mean ΔSER of –1.07 D (SD ±2.85). Baseline SER was a significant predictor of progression (β = –0.96; 95% CI: –1.20 to –0.73; p < 0.001). No significant associations were found between ΔSER and screen or study time. Subgroup analysis showed no difference in progression by family history of myopia.

Conclusion: This study adds to the existing Pakistani literature on myopia among medical students by providing longitudinal data on refractive change over a period of five-year. Findings highlight baseline refractive error as the strongest determinant of progression, emphasizing the need for early detection and targeted surveillance in LMIC academic populations.