DOI: 10.4103/jcor.jcor_371_25 ISSN: 2320-3897

Ocular biometry and refractive error in Malaysian Indian children: First ethnicity-specific norms and evidence of a 30-year myopic shift

Indira Madhavan, Uma Mageswari Batumalai, Fakhruddin Shamsheer Barodawala, Azrin Esmady Ariffin, Gopinath Madheswaran
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Objectives:

This study aimed to determine the relationship between refractive error and ocular biometry, axial length (AL), corneal curvature (CR), central corneal thickness (CCT), and AL/CR ratio, among Malaysian Indian schoolchildren aged 7–11 years. Given the limited biometric evidence for this ethnic group, the study sought to generate population-specific baseline data to support early myopia control strategies.

Materials and Methods:

A cross-sectional analysis was conducted on 179 Malaysian Indian children (358 eyes) recruited from the REKLIS study in Kuala Lumpur. Ocular biometry was obtained using A-scan ultrasound (AL), keratometry (CR), and corneal topography (CCT). The spherical equivalent refraction (SER) was determined using cycloplegic refraction. Participants were categorized into myopic and nonmyopic groups for comparative and correlational analyses.

Results:

The mean SER was −0.70 ± 1.81 D, with a myopia prevalence of 28.9%. This prevalence is higher than that reported in earlier school-based assessments from the same population. Myopic eyes showed longer AL, steeper CR, and higher AL/CR ratios. SER showed negative correlations with AL ( r = −0.40) and AL/CR ratio ( r = −0.55). AL positively correlated with CR ( r = 0.59). In the myopic group, both AL and AL/CR ratio increased with age. No significant gender differences were observed within refractive groups. Comparison with historical data indicated an approximate 1.5 D myopic shift over three decades, accompanied by increases in AL and AL/CR ratio.

Conclusions:

This study establishes the first ocular biometric norms for Malaysian Indian children, revealing AL and AL/CR ratio as key correlates of refractive error and evidence of a 30-year myopic shift in this population.

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