Association of time outdoors and patterns of light exposure with myopia in children

Li, Mijie; Lança, Carla Costa; Tan, Chin Wen; Foo, Li-Lian; Sun, Chen-Hsin; Yap, Fabian; Najjar, Raymond P.; Sabanayagam, Charumathi; Saw, Seang‐Mei

doi:10.1136/bjophthalmol-2021-318918

Cited by 21 publications

(40 citation statements)

References 34 publications

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“…14,15,43 Previous studies have reported that myopic children spend less time outdoors than nonmyopicchildren, as determined using parent questionnaires 12,13,44 and using objective sensors. 23,27,45 Here, myopic children spent approximately half as much time exposed to outdoor bright light compared with nonmyopes on both weekdays and weekend days, as measured objectively with the Clouclip. Surprisingly, time outdoors averaged only 24 minutes on weekdays and 54 minutes on weekend days, significantly less time outdoors than we have found in previous studies.…”

Section: Discussionmentioning

confidence: 92%

Objective Measures of Near Viewing and Light Exposure in Schoolchildren during COVID-19

et al. 2022

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SIGNIFICANCEWearable sensors provide the opportunity for continuous objective measurement of the visual environment with high resolution. Our findings show that absolute and temporal properties of near viewing and time outdoors vary between myopic and nonmyopic schoolchildren, which are important considerations when studying refractive error pathogenesis.PURPOSENumerous behavioral factors, including near work, time outdoors, electronic device use, and sleep, have been linked to myopia. The purpose of this study was to assess behaviors using subjective and objective methods in myopic and nonmyopic schoolchildren in the United States.METHODSForty children (aged 14.6 ± 0.4 years) simultaneously wore two sensors for 1 week, a Clouclip for objective measurement of near viewing and light exposure and an Actiwatch for objective measurement of activity and sleep. Parents completed an activity questionnaire for their child. Near-viewing distance, daily duration, short-duration (>1 minute) and long-duration (>30 minutes) near-viewing episodes, light exposure, time outdoors, electronic device use, and sleep duration were analyzed by refractive error group and day of the week.RESULTSObjectively measured daily near-viewing duration was 6.9 ± 0.3 hours. Myopes spent more time in near + intermediate viewing than nonmyopes (P = .008) and had higher diopter hours (P = .03). Short- and long-duration near-viewing episodes were similar between groups (P < .05 for both). Daily light exposure and time outdoors were significantly lower for myopes (P < .05 for both). Electronic device use (12.0 ± 0.7 hours per day) and sleep duration (8.2 ± 0.2 hours per night) were similar between groups (P > .05 for both).CONCLUSIONSObjective and subjective measures confirm that myopic and nonmyopic schoolchildren exhibit different behaviors. Combining wearable sensors with questionnaires provides a comprehensive description of children's visual environment to better understand factors that contribute to myopia.

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Section: Discussionmentioning

confidence: 92%

Objective Measures of Near Viewing and Light Exposure in Schoolchildren during COVID-19

et al. 2022

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“…Increasing evidence suggests that light intensity is associated with myopia and refractive error change. Li 22 recorded light exposure patterns and self-reported time outdoors and found that more time spent outdoors was associated with lower risk of myopia (OR=0.82, 95% CI=0.70, 0.95, p=0.009). A recent prospective study by Sánchez 23 revealed that children with shorter daylight hours had higher increase in SER over 18 months (p<0.001).…”

Section: Discussionmentioning

confidence: 99%

Influence of Lifestyle Patterns On Myopia In Students Aged 9 To 18 In Tianjin, China: A Latent Class Analysis

Cui

Cao

Liu

et al. 2022

Preprint

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Purpose: This study aims to determine influence of lifestyle patterns on myopia and spherical equivalent refraction (SE) in school-aged children in Tianjin.Methods: Students aged 9 to 18 in grade 4 to 12 were recruited. Non-cycloplegic SE was obtained. A self-administration questionnaire was used to collect demographic and lifestyle information.Results: The overall prevalence of myopia of 8651 students was 81.5% and that of high myopia was 8.88%. Myopia and high myopia rate increased dramatically with grade (p<0.001). Students were classified into 3 groups based on latent class analysis (LCA). Students in class 2 had the lowest myopia rate of 74.1% and those in class 1 had the highest rate of 82.8%. Binary logistic regression analysis showed that class 1 and 3 had a higher risk for myopia compared to class 2 (OR= 1.68, p<0.001; OR= 1.46, p=0.004). The risk for high myopia of Class 1 and 3 were also higher compared to that of class2 (OR= 2.41, p<0.001; OR= 2.13, p=0.006). General linear model showed that SE of students in class 1 and 3 was lower than that of students in class 2 (β=-0.82, p<0.001; β=-0.68, p<0.001).Conclusion: Lifestyle is associated with myopia and SE value.

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“…However, it should be noted the type of sports club was not specified in this study, and it was thought that the exercises performed included both outdoor and indoor activities. Previous studies have reported that although outdoor activity prevented the development of myopia, there was no association between daytime light intensity or time, timing, and frequency spent outdoors [ 30 ]. In addition, mouse experiments have reported that exercise reduces harmful ocular blood vessel overgrowth by up to 45% [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Attending a Sports Club Can Help Prevent Visual Impairment Caused by Cram School in Elementary School Children in Japan

Mineshita

Kim

Shinto

et al. 2021

IJERPH

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Longer durations for near-work activities, such as studying, worsen eyesight. In contrast, outdoor exercise is effective in reducing the risk of developing myopia. Despite these findings, however, the interaction between studying and exercise in eyesight has not been quantitatively evaluated. Moreover, since there is a culture of attending lessons in Japan, it is important to investigate the relationship between elementary school activities, such as cram schools or sports clubs, and vision. Therefore, in this study, we examined whether attending cram schools and/or sports clubs is associated with the use of glasses among elementary school students. We conducted a survey among 7419 elementary school students in Tokyo, Japan using a food education questionnaire. A logistic regression analysis was used to evaluate the relationship between wearing glasses, an objective variable, and attending sports clubs and cram schools. Sex and school year were considered confounding factors. The results of this study showed that students who attended only sports clubs were more likely to be categorized into the “not wearing glasses” group (p = 0.03, OR = 1.45), whereas those who attended only cram schools were more likely to be categorized into the “wearing glasses” group (p = 0.008, OR = 0.67). In addition, students who attended both cram schools and sports clubs were more likely to be categorized into the “not wearing glasses” group than those who only attended cram schools (p = 0.28, OR = 0.85). Our findings indicate that attending not only cram schools but also sports clubs may prevent deterioration of eyesight. Parents and health care providers need to take these findings into account in order to prevent visual impairment in children.

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Association of time outdoors and patterns of light exposure with myopia in children

Cited by 21 publications

References 34 publications

Objective Measures of Near Viewing and Light Exposure in Schoolchildren during COVID-19

Objective Measures of Near Viewing and Light Exposure in Schoolchildren during COVID-19

Influence of Lifestyle Patterns On Myopia In Students Aged 9 To 18 In Tianjin, China: A Latent Class Analysis

Attending a Sports Club Can Help Prevent Visual Impairment Caused by Cram School in Elementary School Children in Japan

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