Rising burden of myopia among South Korean young adults based on 13-year trends, associated factors, and projections to 2050

To investigate long-term and projected trends of myopia and high myopia among young South Korean males and to evaluate associated sociodemographic risk factors. A repeated cross-sectional analysis was conducted using medical records from 4,063,091 19-year-old conscripts between 2011 and 2023. Logistic regression identified myopia risk factors, while linear regression assessed temporal trends. Projection modeling estimated future prevalence through 2050. Myopia prevalence increased from 50.6% in 2011 to 59.8% in 2023, and high myopia from 14.3% to 17.7%. Higher education was strongly associated with both conditions (P < 0.001), yet the gap narrowed. In 2011, odds of myopia and high myopia were over threefold higher in the most educated versus least educated groups (OR = 3.20 and OR = 3.03), but by 2023 had declined to approximately twofold (OR = 2.00 and OR = 1.99). Urban residents consistently showed higher risk compared with rural dwellers (P < 0.001), though disparities also narrowed (high myopia OR = 1.52 in 2011 vs. OR = 1.37 in 2023). Body stature indicators showed no consistent associations. Projection models suggested prevalence may reach 84% for myopia and 28% for high myopia by 2050. In this nationwide study, myopia and high myopia rose substantially over 13 years with narrowing sociodemographic disparities. Projections indicate further escalation, underscoring the urgent need for national prevention strategies.