The relationship between myopia and near work, time outdoors and socioeconomic status in children and adolescents

Abstract

Background To investigate environmental and social risk factors for myopia in children and adolescents in Germany. Methods 1437 children aged between 3 and 18 inclusive were examined as part of the LIFE Child study based in Leipzig, Germany. Information about leisure time activities and social status was ascertained by parents and children in a questionnaire. Refractive status was attained by measuring noncycloplegic autorefraction. Myopia was defined as spherical equivalent (SE) ≤ − 0.75 D. Risk factors were identified using multiple logistic regression analysis. Results In multiple logistic regression analysis, myopia was significantly associated with less frequent outdoor activity (“once a week” vs. “twice a week or more”: odds ratio (OR) 4.35, 95% confidence interval (CI) 1.89–9.98, p<0.01) and longer near work sessions (1–2 h vs. < 1 h: OR 1.83, CI 1.10–3.04, p=0.02; > 3 h vs. < 1 h: OR 3.71, CI 1.43–9.61, p<0.01) after adjustment for age, sex and socioeconomic status (SES). Duration of outdoor activity, near work frequency and SES showed no significant association with myopia (p > 0.05). Children with a lower SES were involved in longer periods of outdoor and near work activities but on fewer occasions over the course of the week, although this connection was not significant. Conclusion Myopia is associated with environmental factors. The present findings suggest that daily exposure to sunlight and a restriction of long-duration near work activities might protect against pathological eye growth. Prevention strategies should be implemented for children at all ages.

The influence of the environment and lifestyle on myopia

“…The authors proposed that economic development fosters a desire for wealth, leading to increased educational pursuit and heavier academic burdens, ultimately resulting in higher myopia rates [ 266 ]. While other studies found higher socioeconomic status to be associated with myopia [ 264 , 265 , 267 , 268 ], some failed to find any such association [ 61 , 187 , 269 ]. The conflicting evidence on socioeconomic status and myopia may stem from variations in the definition and classification of socioeconomic status, as well as unmeasurable factors like parental involvement and academic pressure.…”

Effect of multifocal spectacle lenses on accommodative errors over time: Possible implications for myopia control

“… Pärssinen & Kauppinen (2022) have found an association between close work time and incidence of myopia in a historical survey of around 5000 Finnish children. An association between longer near work sessions and incidence of myopia has been also been recently found in around 1400 children aged between three and 18 years old ( Philipp et al, 2022 ). Close work is associated with the fovea and perifovea experiencing accommodative lag, not the peripheral retina, which has mostly accommodative lead during close work ( Flitcroft, 2012 ).…”

Normative data for macular and retinal nerve fibre layer thickness in healthy German children and adolescents using optical coherence tomography

“…However, since this correlation contradicts the assumption that more outdoor time tends to prevent myopia or myopic progression, 60 it should be questioned critically. This is emphasised by the fact that in our LIFE cohort of children, those who were outdoors more frequently during the week were also less myopic 61 …”

“…This is emphasised by the fact that in our LIFE cohort of children, those who were outdoors more frequently during the week were also less myopic. 61…”