Background: To investigate the distribution of refractive errors and their characteristics in older adults. Methods: The study design was cross-sectional study. A total of 1107 men and women were interviewed and underwent detailed ophthalmic examinations, 998 subjects underwent refraction. Myopia was defined as spherical equivalent (SER) refraction ≤ −0.5 dioptres (D) and hyperopia was defined as SER ≥ +0.5 dioptres (D). Results: Among those who were refracted the distribution of myopia and hyperopia was 24.1% (95% CI 21.4–26.7) and 37.5% (95% CI 34.5–40.5), respectively. Myopia decreased from 28.7% in subjects aged 35-59 years to 19.3% in those aged 60 years or older and hyperopia increased from 21.8% at 35–59 years of age to 53.3% in subjects aged ≥60 years. Multiple regression analysis showed decreasing age (OR 0.98, 95% CI 0.96–1.00), female gender (OR 1.87, 95% CI 1.18–2.95) and presence of cataract (OR 2.40 , 95% CI 1.24–4.63) were independent risk factors associated with myopia. Conclusions: The distribution of refractive errors found in our study is similar to those reported in other Caucasian populations and differs from Asian populations. Myopia was positively associated with younger age, female gender and presence of cataract.

Children with autism spectrum disorder (ASD) may have impaired vision from high refractive errors: near-sighted-myopia or far-sighted-hyperopia and aversion to spectacles or contact lenses. Refractive surgery can restore sharp vision and eliminate the need for spectacles or contact lenses. Restoration of sharp vision may improve ASD behaviors. Data were collated retrospectively for 267 children with refractive errors and neurodevelopmental disorders (NDD) diagnosed as ASD alone or NDD with ASD-like behaviors. Surgery was either laser photo-refractive keratectomy (PRK; 131 children), implantation of a phakic intra ocular lens (pIOL; 129 children) or removal of the crystalline lens and implantation of an IOL (refractive lens exchange, RLE; 21 children) under general anesthesia. Median age was 10.9 yrs. and median follow-up 3.1 yrs. Pre-operative refractive errors ranged from a mean +7.5 ± 0.9 D to -14.3. ± 4.8 D. Surgery corrected 87% to normal focal length (± 1 D). Visual acuity improved an average 0.6 logMAR. Social interactions and ASD behaviors improved in 55% (146/267) of the treated children (p < .01), including school performance; motor skills; depth perception; repetitive or stereotyped movements; anxiety/fear; and attention. Refractive surgery improves both visual function and behaviors in the majority of highly near-sighted or far-sighted children with ASD.