Is there a link between passive smoke exposure and early-onset myopia in preschool Asian children?

Sharon Yu Lin Chua, Mohammad Kamran Ikram, The GUSTO Study Group, Chuen Seng Tan, Richard A. Stone, Shirong Cai, Peter D. Gluckman, Seng Chong Yap, Fabian Yap, Tien Yin Wong, Cheryl S. Ngo, Seang Mei Saw*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

13 Citations (Scopus)


PURPOSE: To investigate the association of passive tobacco smoke exposure with early-onset myopia among three-year-old children in Singapore.

METHODS: Pregnant mothers who attended their first trimester clinic at two major maternity units were recruited into the GUSTO birth cohort. The current analysis comprised 572 three-year-old children, who underwent cycloplegic autorefraction and axial length (AL) measurements. Myopia was defined as spherical equivalent (SE) of ≤-0.50 dioptres (D). Either parent completed questionnaires describing their child's exposure to passive smoke at six months, one and two years of age.

RESULTS: There were 197 children (36.2%) who were exposed to passive smoke from birth to before six months. Compared to non-exposed children, children exposed to any passive smoke from birth to before six months experienced greater myopia prevalence (adjusted OR = 2.79; 95% CI: 1.24-6.29; p = 0.01). The odds of myopia in a child was greater if a smoker smokes at home, in the family car, or in the presence of the child (adjusted OR = 3.95; 95% CI: 1.41-11.09; p < 0.01) compared to non-exposed child. In contrast to myopia, childhood exposure to passive smoke did not systematically shift mean values for SE or AL.

CONCLUSIONS: In this prospective birth cohort study, we found that childhood exposure to passive smoke from birth to before six months slightly increased the risk of early-onset myopia. This may indicate a delayed response to passive smoke exposure before six months and the development of myopia at three years of age. Our study is limited by the small number of myopic children at this young age. Thus, larger prospective studies using more objective cotinine level measures are required to fully establish and understand the influence of tobacco smoke on refractive development in older children.

Original languageEnglish
Pages (from-to)370-380
Number of pages11
JournalOphthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)
Issue number4
Publication statusPublished - Jul 2016
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2016 The Authors Ophthalmic & Physiological Optics © 2016 The College of Optometrists.


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