Ocular biometric profile and clinical characteristics of high myopia in Indian children.

PURPOSE: To profile ocular biometric parameters and clinical features in Indian children with high myopia.

METHODS

We conducted a retrospective chart review of electronic medical records at a tertiary care center from September 2023 to March 2025. Children ≤16 years with high myopia (spherical equivalent [SE] ≤ -6.00 D) and complete biometric data were included. Cycloplegic refraction, axial length (AL), keratometry (K), anterior chamber depth (ACD), lens thickness (LT), central corneal thickness, and clinical findings of one eye per patient (left eye by convention) were extracted and analyzed. Correlations between SE and biometric variables were assessed using Pearson's correlation and multiple linear regression.

RESULTS

A total of 123 eyes from 123 patients (mean age 11.2 ± 3.5 years; 53% male) were analyzed. Mean SE was -9.84 ± 2.77 D (range -6.0 to -18.9 D), and mean AL was 26.39 ± 1.39 mm (range 23.75-30.46 mm). SE showed a strong correlation with AL (r = -0.777, P < 0.001) and a moderate correlation with LT (r = -0.281, P = 0.001) but a negligible association with K. Multiple regression incorporating AL, K, ACD, and LT explained 70.8% of SE variance (adjusted R² = 0.789, P < 0.0001). Retinal changes were present in 32.5% of eyes, most commonly tessellated fundus (29%), and all eyes with AL >28 mm showed fundus abnormalities.

CONCLUSION

High myopia in Indian children is characterized by early axial elongation, severe refractive error, and early retinal changes. Axial length remains the principal determinant of myopia, though keratometry, lens thickness, and ACD provide additional predictive value.