Justin Cooper , 2025-04-22 18:17:00
April 22, 2025
2 min read
Key takeaways:
- Signs of tissue hyperlaxity were significantly more common among those with myopia than without.
- Clinicians may look for musculoskeletal abnormalities in those with myopia and other risk factors.
Adolescents with myopia had hernias, scoliosis and flat feet significantly more often than those without, suggesting a possible link between nearsightedness and overall connective tissue hyperlaxity, according to a study.
“Previous studies have established a relationship between syndromic connective tissue disorders, such as Marfan syndrome or Ehlers-Danlos syndrome, and myopia. However, the association between non-syndromic connective tissue hyperlaxity and myopia had not been systematically examined,” Itay Nitzan, MD, MPH, of the department of ophthalmology at Shamir Medical Center, in Israel, told Healio. “Given the increasing prevalence of myopia worldwide, and its emerging recognition as a systemic marker in certain conditions, we aimed to investigate whether habitual markers of tissue hyperlaxity are more prevalent among adolescents with myopia.”
Image: Hadassah Medical Organization
In a study published in Clinical & Experimental Ophthalmology, Nitzan and colleagues analyzed the medical records of 920,806 adolescents (mean age, 17.4 years; 58.6% men) who underwent standardized medical evaluation as part of Israel’s military draft between 2011 and 2022.
“This unique dataset includes both objective ophthalmic examinations and comprehensive medical histories,” Nitzan said.
The researchers compared the prevalence of signs of tissue hyperlaxity (including diagnoses of hernias, flat feet, bowlegs, knock-knees, scoliosis and joint injuries) between participants with myopia and those without myopia.
Overall, 31.6% of the participants had myopia (n = 290,759). According to the analysis, those with myopia had statistically significantly higher prevalences of:
- hernias (2.76% vs. 2.60%);
- flat feet (14.92% vs. 13.51%); and
- scoliosis (9.14% vs. 7.69%).
Adolescents with or without myopia had clinically similar rates of ankle, shoulder and knee injuries, with a less than 0.1% difference in each. Nitzan highlighted this lack of association, noting that joint injuries are “often considered indicative of laxity.”
“We hypothesize that this may reflect behavioral differences, such as physical activity, which could confound the association,” he said.
Overall, the findings support the idea of the eye serving as “a window into broader systemic connective tissue traits,” Nitzan said.
“This study suggests that myopia, beyond being a refractive condition, may be part of a broader systemic phenotype involving connective tissue laxity,” he said. “Clinicians might consider assessing for musculoskeletal abnormalities in patients with myopia, especially when other symptoms or risk factors are present.
“If validated, these associations could inform more personalized approaches to monitoring and potentially preventing myopia progression,” he added. “Further research is needed to clarify the shared biological pathways involved.”
For more information:
Itay Nitzan, MD, MPH, can be reached at itay.nitzan@mail.huji.ac.i.
