Myopia is often regarded as a minor priority in public health research, yet the public health costs of myopia are considerable, both due to the costs of optical correction and from the costs imposed by the morbidity resulting from myopia in terms of associated eye disease (glaucoma, posterior subcapsular cataract), and the visual impairment and blindness that can result from myopia due to myopic retinal degeneration and retinal detachment. There is clear evidence for a high and increasing prevalence of myopia in East Asia, apparently driven by increasing educational pressures and urbanization. Data from the USA, Europe and Australia are consistent with the data from Asia in terms of the role of these risk factors. However, the evidence for an increasing prevalence of myopia is more problematic, due to the lack of adequate longitudinal studies, and the confounding effects of age-related hypermetropization. It is concluded that the prevalence of myopia is probably increasing in Australia, although the changes are of much lower magnitude than n East Asia. Longitudinal studies are, therefore, clearly required to quantify changes in the prevalence of myopia in Australia, for accurate assessment of the public health impacts and to assist with the development of preventive approaches.