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Association Between Hay Fever and High Myopia in United States Adolescents and Adults

Shafer, Brian M. B.S.; Qiu, Mary M.D.; Rapuano, Christopher J. M.D.; Shields, Carol L. M.D.

Eye & Contact Lens: Science & Clinical Practice: May 2017 - Volume 43 - Issue 3 - p 186–191
doi: 10.1097/ICL.0000000000000251

Objectives: To investigate the relationship between hay fever and refractive error in a representative sample of adolescents and adults in the United States.

Methods: This cross-sectional study included 5,744 participants aged ≥12 years from the 2005 to 2006 National Health and Nutrition Examination Survey who participated in the allergy questionnaire, completed objective refraction and keratometry in both eyes, and had immunoglobulin E (IgE) serology. The primary predictor variable, refractive error, was classified as emmetropia (−0.99 to +0.99 diopters [D]), low myopia (−1.00 to −2.99 D), moderate myopia (−3.00 to −5.99 D), high myopia (≥−6.00 D), or hyperopia (≥1.00 D). Covariates included age, gender, race, asthma, eczema, total serum IgE ≥120 kU/L, corneal steepness, and corneal astigmatism. The primary outcome was hay fever.

Results: The study population's mean age was 41.7 years; 48.8% of subjects were men and 51.2% were women. The prevalence of hay fever was 12.1% overall. High myopes had 2.7 times higher odds of hay fever compared to emmetropes (OR 2.67, CI, 1.57–4.51, P=0.001), which was independent of demographics, atopic conditions, IgE serology, and keratometry measurements.

Conclusions: The association between hay fever and high myopia identified in this large cross-sectional study remains speculative and was not mediated through corneal steepness or corneal astigmatism. Further prospective studies may help elucidate the directionality of the association between hay fever and high myopia.

Temple University School of Medicine (B.M.S.), Philadelphia, PA; Wilmer Eye Institute (M.Q.), Johns Hopkins University, Baltimore, MD; Cornea Service (C.J.R.), Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA; and Ocular Oncology Service (C.L.S.), Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA.

Address correspondence to Mary Qiu, M.D., Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, 840 Walnut Street, Suite 1440, Philadelphia, PA 19107; e-mail:

The authors have no conflicts of interest to disclose.

Support provided by the Eye Tumor Research Foundation, Philadelphia, Pennsylvania (C.L.S.). The funders had no role in the design or conduct of the study, in the collection, analysis and interpretation of the data, and in the preparation, review or approval of the article. B. M. Shafer had full access to all the data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis.

Accepted December 23, 2015

© 2017 Contact Lens Association of Ophthalmologists, Inc.