Objectively measured near work, outdoor exposure and myopia in children

Abstract

AimTo reassess the association between near work, outdoor exposure and myopia in children through an objective approach.MethodsEighty-six children (10.13±0.48 years) were asked to wear Clouclip, a newly developed wearable device that is able to measure working distance and eye-level illuminance, for a complete week to obtain information on near work and outdoor exposure. The mean daily Clouclip wearing time was 11.72±1.14 hour. The spherical equivalent refraction was determined by cycloplegic autorefraction.ResultsThe myopic children were found to be exposed to light intensities >3000 lux (0.68±0.50 hour vs 1.02±0.53 hour, p=0.012) and >5000 lux (0.42±0.35 hour vs 0.63±0.31 hour, p=0.004) for shorter durations on average each day than the non-myopic children. Additionally, the myopic children spent more time on average each day on activities at a distance of <20 cm than non-myopic children (1.89±0.61 hour vs 1.52±0.77 hour, p=0.019). In the multivariate logistic analysis, the time spent with a higher light intensity (>3000 lux (OR=0.27, 95% CI: 0.10 to 0.72, p=0.009); >5000 lux (OR=0.11, 95% CI: 0.02 to 0.56, p=0.008)) and a working distance of <20 cm (in a circumstance of >3000 lux (OR=1.17, 95% CI: 1.09 to 1.86, p=0.038) or in that of >5000 lux (OR=1.12, 95% CI: 1.03 to 1.77, p=0.046)) were the independent protective factors and risk factors, respectively.ConclusionThe current study provides novel evidence, based on objective data, to support the association between the intensity of near work, light intensity and myopia. However, the causality and the dose-effect relationship need to be investigated further.

Validation of the Clouclip and utility in measuring viewing distance in adults

“…Reported range of the second generation Clouclip for distance tracking is 5 to 120 cm, with a 25°beam diameter and a 10°inferiorly directed beam angle, and 1 to 655 336 lux for ambient illumination measurement. 47,48…”

Stability of Ophthalmic Atropine Solutions for Child Myopia Control

“…The prevalence of myopia is variable between countries, affecting for example about 30% of young adults in Europe [ 2 ], 59% in North America [ 3 ], to more than 95% in some student populations of Asian countries [ 4 , 5 ], with onset of the disease occurring during childhood and adolescence. Many risk factors have been suggested or clearly identified, such as time spent performing close-vision activities, such as reading or looking at smart-device screens [ 6 ], lack of physical exercise, or exposure to sunlight [ 3 , 7 ], often all linked to higher education rates [ 8 ]. If left uncorrected, myopia has been shown to have major consequences on children’s level of education, quality of life, and personal and psychological well-being [ 9 ], and its economic impact on society has been estimated at US$244 billion from global potential productivity loss [ 10 ].…”

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“…Text size of twice the individual's visual acuity is recommended for young, visually normal subjects for sustained comfortable reading from a laptop computer. [ 19 ] Wearable trackers, such as the Clou-clip[ 20 ] and smartwatch based devices,[ 21 ] also have their application in the current situation and near future to understand the visual behavior, near work profile, and light exposure such that practitioners and parents gain deeper insights into these modifiable risk factors.…”