No myopia epidemic among German children over 25 years, large-scale study confirms
A new analysis of over 1.2 million eyeglass prescriptions covering nearly 438,000 children finds no rise in myopia in Germany from 2001 to 2025, contradicting global concerns of a myopia epidemic.
The data: no rise in myopic prescriptions
The research, published in Frontiers in Public Health, drew on 1.25 million eyeglass prescriptions issued to about 437,700 children between ages 3 and 18 from 2001 to 2025. The data came from real optician records, not standardised ophthalmological examinations, meaning it only captures children who actually received glasses. Myopia was set at minus 0.50 diopters or worse. Over the entire 25-year stretch, the likelihood of receiving a prescription for myopia remained stable, and the average prescription strength did not increase. The researchers also caution that their dataset cannot detect uncorrected myopia, so children with mild visual issues who never got glasses are absent from the analysis.
Contrary to the widespread assumption of a rapidly accelerating global myopia epidemic, we found no increase in myopic eyeglass prescriptions between 2001 and 2025.
The team also noted that glasses are now prescribed at slightly younger ages, but they suspect this reflects increased parental and medical vigilance rather than a genuine decline in children’s eyesight. The finding matches a recent European meta-analysis indicating myopia prevalence across the continent has stagnated since the turn of the millennium.
Europe’s plateau vs Asia’s surge
In East Asia, the situation is dramatically different. Young-adult myopia rates there rocketed from 20–40% before World War II to 60–90% today. The Freiburg researchers point to extremely intense, early academic pressure and a severe deficit of outdoor time as the main accelerators. By contrast, German children typically spend more hours outside and face a less exam-driven educational system, which likely explains the plateau.
Screen time: the dose-response risk
The authors also addressed screen time. Their review of the evidence found that less than one hour of daily screen use carries almost no extra myopia risk. Each additional hour beyond that, however, adds a roughly 20% higher risk, up to about five hours. Beyond that threshold, the risk curve flattens, and further increments add only marginal extra danger.
- 1 h
- 1 relative risk
- 2 h
- 1.2 relative risk
- 3 h
- 1.4 relative risk
- 4 h
- 1.6 relative risk
- 5 h
- 1.8 relative risk
- 6 h
- 1.85 relative risk
The article stresses that this dose-response pattern means that moderate screen engagement, especially when balanced with outdoor time, is not as harmful as some alarmist narratives suggest.
No pandemic spike
The COVID-19 pandemic and the attendant digital surge prompted concerns that quarantined children would suffer a myopia boom, as documented in several Asian studies. The German data provide no evidence for such a spike.
This refutes the fear that the COVID-19 pandemic and increasing digitalisation in Germany caused a rise in myopia during quarantine, as reported in other, primarily Asian studies.
The study concludes that Germany’s environment and lifestyle appear to effectively buffer children against the global trend of worsening eyesight, at least so far.
