Myopia progression in young adults: a literature review

Background. Myopia onset and progression are generally associated with school age; however, axial elongation and myopic progression have also been documented in some individuals older than 18 years. Data on myopia in young adults remain limited. Important unresolved issues include the age at which myopia stabilizes after adolescence, the occurrence of incident myopia in young adulthood, the rate of progression, and the identification of risk factors and effective control strategies. Purpose: To synthesize the current evidence on the onset and progression of myopia in adults aged 18 to 40 years and to identify gaps in understanding of risk factors and the effectiveness of myopia control interventions. Materials and methods. A literature review and analysis of original studies indexed in PubMed, MEDLINE, and eLibrary and published between 1987 and 2025 was performed. Eighty-nine publications met the initial inclusion criteria: original studies and reviews; participant age 18–40 years; and quantitative data on changes in refractive error and/or axial length. Of these, 46 studies were included in the final review. Results. Over the past decade, growing evidence has shown that myopia may continue to progress in adulthood, challenging the widely held view that it stabilizes in late adolescence. Clinically meaningful progression can reach approximately 1.00 D between 20 and 30 years of age. Although several myopia control interventions have demonstrated efficacy in children, there is currently no convincing evidence supporting their use in young adults. Factors potentially associated with myopia progression in this age group include genetic predisposition, demographic characteristics, and environmental exposures. Conclusion. Myopia progression in young adults is clinically relevant, but the timing of stabilization and the underlying risk factors remain poorly understood. Further studies are needed to identify structural and biometric predictors of axial elongation and to evaluate the effectiveness of myopia control strategies in young adults.

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