A study led by researchers at NOVA Medical School identifies an overestimation of myopia in Europe and highlights the urgent need for more rigorous and standardized diagnostic methods in future studies on Europeans' visual health. Published in The Lancet Regional Health – Europe, the research led by André Rosário (Professor and Researcher at NOVA Medical School) is the first systematic review in Europe to examine the prevalence of myopia based on the diagnostic method used, emphasizing the importance of cycloplegic refraction (CR) to obtain more accurate estimates.
The combined analysis of data from 14 European countries shows a myopia prevalence of 23.5%. However, this figure drops significantly to 18.9% when considering only studies that used cycloplegic refraction — the most accurate eye exam for diagnosing myopia, as it eliminates the effect of ocular accommodation, especially relevant in children.
This research raises the bar for ophthalmology studies by demonstrating that diagnostic methods significantly affect prevalence estimates, with direct implications for screening strategies, prevention policies, and clinical interventions. The study also highlights substantial differences between countries, ranging from 11.9% in Finland to 49.7% in Sweden.
“Our study shows that myopia is consistently overestimated in Europe when rigorous methods such as cycloplegic refraction are not used,” explains André Rosário, from NOVA Medical School and the Comprehensive Health Research Centre (CHRC). “This has serious implications for public policy design, especially if based on inflated data,” he adds.
The authors applied strict inclusion criteria, excluding studies with unrepresentative samples, self-reported data, diagnoses based solely on visual acuity, and clinical or pathology-specific populations.
According to André Rosário, “it is precisely due to these strict criteria that Portugal was not included in the analysis, as no national study met the required methodological standards.”
Although the study is focused on Europe, the absence of high-quality studies from Portugal should be seen as a warning sign. “It is urgent to strengthen national research in this field and align methodologies with international standards. Without that, the data do not reflect reality and are of little use for strategic health planning,” he stresses. “We need longitudinal, methodologically robust studies using cycloplegic refraction, with broader geographic coverage and age-group segmentation.”
The study was co-authored by Carla Lança (NYU Abu Dhabi and CHRC/ENSP-NOVA) and Polish expert Andrzej Grzybowski. It demonstrates that global myopia estimates may be inflated if standardized and reliable diagnostic methods are not used. The global figures have shown a dramatic rise in myopia, particularly in East Asia, with projections indicating that nearly half of the world’s population may be affected by 2050.
Myopia is not just a visual condition — it is associated with an increased risk of severe eye diseases and even dementia. Early detection and proper management can help reduce long-term health and economic impacts.
This study marks an important step in understanding myopia in Europe and further establishes NOVA Medical School as a scientific reference in setting quality standards for vision research.
Read the full study here.