Meta-analysis in BMC Ophthalmology: eye pressure shows no stable link to myopia in 13,451 children
Pooled data from nineteen observational studies show only a weak negative link between intraocular pressure and refraction in healthy children; it lost significance after adjustment.
A systematic review and meta-analysis published in BMC Ophthalmology evaluated the association between intraocular pressure (IOP) and refractive status in children and adolescents. The authors included nineteen observational studies with 13,451 participants. Searches ran from database inception to March 3, 2026 biomedcentral.com
BMC Ophthalmologybiomedcentral.comOpen source ↗.
Myopia is a major cause of visual impairment worldwide, and IOP has been considered a promising factor associated with its progression. Some studies reported that IOP correlates with spherical equivalent (SE) and axial length (AL), while others did not, so the literature remained inconsistent.
Search and methods
The team searched PubMed, Embase, the Cochrane Library, Web of Science Core Collection, Ovid, CNKI and the Wanfang database. They looked for observational studies that reported the correlation between IOP and refractive parameters. Correlation coefficients were pooled with random-effects models, and the certainty of the evidence was assessed with the GRADE approach.
What the pooled data show
The pooled negative correlation between IOP and SE was statistically significant. After a trim-and-fill adjustment for small-study effects, it became non-significant. No significant correlation was found between IOP and axial length, or between IOP and SE progression biomedcentral.com
BMC Ophthalmologybiomedcentral.comOpen source ↗.
Subgroup analyses indicated that the clinical setting and the sample size were significant sources of heterogeneity in the IOP–SE correlation.
The authors conclude that IOP in healthy children and adolescents has a weak negative association with SE and no significant association with AL. The IOP–SE association was not robust in the trim-and-fill sensitivity analysis. According to the authors, IOP should not be assumed to track refractive status or axial elongation in healthy pediatric populations without further consistent evidence.
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