Association Between Hay Fever and High Myopia in United States Adolescents and Adults

Abstract

Objectives: To investigate the relationship between hay fever and refractive error in a representative sample of adolescents and adults in the United States. Methods: This cross-sectional study included 5,744 participants aged ≥12 years from the 2005 to 2006 National Health and Nutrition Examination Survey who participated in the allergy questionnaire, completed objective refraction and keratometry in both eyes, and had immunoglobulin E (IgE) serology. The primary predictor variable, refractive error, was classified as emmetropia (−0.99 to +0.99 diopters [D]), low myopia (−1.00 to −2.99 D), moderate myopia (−3.00 to −5.99 D), high myopia (≥−6.00 D), or hyperopia (≥1.00 D). Covariates included age, gender, race, asthma, eczema, total serum IgE ≥120 kU/L, corneal steepness, and corneal astigmatism. The primary outcome was hay fever. Results: The study population's mean age was 41.7 years; 48.8% of subjects were men and 51.2% were women. The prevalence of hay fever was 12.1% overall. High myopes had 2.7 times higher odds of hay fever compared to emmetropes (OR 2.67, CI, 1.57–4.51, P=0.001), which was independent of demographics, atopic conditions, IgE serology, and keratometry measurements. Conclusions: The association between hay fever and high myopia identified in this large cross-sectional study remains speculative and was not mediated through corneal steepness or corneal astigmatism. Further prospective studies may help elucidate the directionality of the association between hay fever and high myopia.