PURPOSE: The aim of this study was to investigate the changes in biometric measurements and corresponding refractive errors during a three-year period among university students exposed to high educational demands. METHODS: A three-year longitudinal cohort study was performed among 149 Norwegian engineering students (79 females and 70 males, mean age 20.6+/-1.2 years) measuring their refraction and ocular dimensions at the beginning and at the end of the period. The examinations included refraction, keratometry, and A-scan ultrasonographic measurements of the ocular components, all made in cycloplegia. RESULTS: After three years the mean refractive change was -0.52+/-0.45 D (p