Prevalence of Myopia in Europe: An Umbrella Review of Systematic Reviews and Meta-Analyses.

PURPOSE: Myopia is a growing public health concern worldwide. Although several systematic reviews and meta-analyses have evaluated its prevalence in Europe, findings remain inconsistent due to methodological differences. This umbrella review critically synthesised the available evidence and provided a pooled prevalence estimate based on non-overlapping primary studies.

METHODS

PubMed, Web of Science and Embase were searched systematically up to February 2026 for systematic reviews and meta-analyses reporting myopia prevalence in Europe. Methodological quality was assessed using AMSTAR 2. Overlap of primary studies across reviews was mapped, and a secondary random-effects meta-analysis including only unique studies was performed to avoid double counting. Subgroup analyses were conducted by age group and refractive assessment method (cycloplegic vs non-cycloplegic).

RESULTS

Five systematic reviews and meta-analyses were included. Four recent reviews demonstrated high methodological quality according to the AMSTAR 2 criteria. Considerable overlap of primary studies was identified across reviews, supporting the need for an umbrella review approach. The secondary meta-analysis included 40 unique primary studies comprising 200,127 participants and 33,153 myopia cases. Most included studies defined myopia as a spherical equivalent refraction of ≤-0.50 D, although some studies used alternative thresholds. The pooled prevalence of myopia among European children and adolescents was 12% (95% CI: 9-15%). Age-stratified analyses showed a prevalence of 8% (95% CI: 6-12%) in children <12 years and 23% (95% CI: 13-33%) in individuals ≥12 years of age. Studies using non-cycloplegic refraction reported slightly higher prevalence estimates (14%) than those using cycloplegic refraction (12%); however, the difference was not significant (p = 0.45).

CONCLUSION

Approximately one in eight European children and adolescents is myopic, and prevalence increases substantially with age. Differences related to refractive assessment methodology should be interpreted cautiously, as no significant differences were observed between cycloplegic and non-cycloplegic studies.