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—We agree with Dr Letocha that the reported association of myopia with higher income and higher educational levels is consistent with more than one hypothesis about the underlying cause or causes of myopia. As we and others have suggested, the finding could be explained by an association between near work and income and educational levels. However, we cautioned that genetic variation along social class lines could confound this conjecture. If such variation existed, the association between myopia and income and educational levels could have a genetic basis, as postulated by Dr Letocha and others. Unfortunately, our data do not allow us to determine which, if either, hypothesis is correct.We are intrigued by Dr Letocha's clinical observation that myopia has a bimodal distribution. We would be interested in seeing data to that effect.
Sperduto RD, Roberts J, Seigel D, Rowland M. Myopia-Reply. Arch Ophthalmol. 1983;101(8):1301. doi:10.1001/archopht.1983.01040020303030