Outdoor Activity and Myopia among Primary Students in Rural and Urban Regions of Beijing

Yin, Guisheng; Liu, Li Juan; Xu, Liang; Lv, Yan; Tang, Ping; Feng, Yi; Meng, Meng; Jonas, Jost B.

doi:10.1016/j.ophtha.2012.07.086

Cited by 205 publications

(215 citation statements)

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“…[37][38][39] In addition, it appears that progression of myopia might be slower in summer months compared with other months 40,41 indicating a possible protective role for light, and some preliminary work with animal models has shown that bright light can prevent the development of form deprivation myopia. 42,43 Although the exact mechanism by which outdoor activity mediates development and progression of refractive errors remains unclear, elevation of retinal dopamine activity, reduced accommodative response, and spectral composition of light have been suggested as possible factors.…”

Section: Outdoor Activitymentioning

confidence: 99%

Practical applications to modify and control the development of ametropia

Sankaridurg¹,

Holden²

2013

Eye

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For many individuals, the developmental trend of lessening hyperopia from birth continues past emmetropia towards myopia during childhood. The global pattern for prevalence of refractive errors indicates that the prevalence of hyperopia is low; in contrast, the burden of myopia is on the rise because of rising prevalence and magnitude of myopia. This review highlights the need to lessen the global burden of myopia by intervening with the development and/or slowing the progression of myopia. Further, outcomes from human clinical trials of pharmaceutical, optical, and environmental approaches to control myopia will be summarised. Pharmaceutical treatments are effective in controlling eye growth but are associated with deleterious side effects. Optical strategies that induce myopic defocus at the retina such as peripheral defocus reducing lenses, simultaneous defocus lenses, bifocals, and orthokeratology as well as environmental influences such as increased outdoor activity show promise and provide a substantially risk-free environment in which to control eye growth.

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Section: Outdoor Activitymentioning

confidence: 99%

Practical applications to modify and control the development of ametropia

Sankaridurg¹,

Holden²

2013

Eye

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“…The relatively consistent findings from studies of a range of pediatric populations across different geographic locations, demonstrating an association between more outdoor activity and less prevalence (Parssinen & Lyyra, 1993;Mutti et al, 2002;Onal et al, 2007;Rose et al, 2008a;Rose et al, 2008b;Dirani et al, 2009;Deng et al, 2010;Donovan et al, 2012;Fujiwara et al, 2012;Guggenheim et al, 2012;Cui et al, 2013;French et al, 2013cFrench et al, , 2013bGuo et al, 2013a;Wu et al, 2013;Read et al, 2014;He et al, 2015) and incidence (Parssinen & Lyyra, 1993;Jones et al, 2007;Onal et al, 2007;Guggenheim et al, 2012;French et al, 2013cFrench et al, , 2013bWu et al, 2013;He et al, 2015) of myopia support a potential role of light exposure in the development of myopia. Furthermore, the documented seasonal variations in myopia progression/axial 46 Chapter 2: Measurement duration and frequency impact objective light exposure measures elongation (with slower progression found in summer, where the amount of available environmental light is greater compared to winter) (Deng et al, 2010;Donovan et al, 2012;Fujiwara et al, 2012;Cui et al, 2013;Gwiazda et al, 2014) also emphasises the potential importance of ambient light exposure in the regulation of eye growth.…”

Section: Hypothesismentioning

confidence: 89%

“…Several studies have shown that children who spend more time outdoors are less likely to become myopic (Parssinen & Lyyra, 1993;Mutti et al, 2002;Jones et al, 2007;Rose et al, 2008a;Rose et al, 2008b;Dirani et al, 2009;Jones-Jordan et al, 2011;Guggenheim et al, 2012;French et al, 2013a;French et al, 2013c;Guo et al, 2013a;Wu et al, 2013;Read et al, 2014;He et al, 2015;Li et al, 2015b;Guo et al, 2017) (Table 1.1). Low levels of outdoor activity have been reported in children living in urban Beijing (1 hour/day) (Guo et al, 2013a), Taiwan (0.5 hours/day) and Singapore (0.5 hours/day) (Rose et al, 2008b), and all of these locations are documented to have a high prevalence of myopia in young populations. A study of school students of Chinese ancestry in Singapore and Sydney showed that myopia prevalence was higher in Chinese children living in Singapore, and the time spent outdoors was the major distinguishing factor between the two groups (Rose et al, 2008b).…”

Section: Outdoor Activitymentioning

confidence: 99%

“…Epidemiological studies have also provided evidence supporting a possible role for ambient light exposure as an additional important environmental risk factor associated with myopia development (Parssinen & Lyyra, 1993;Mutti et al, 2002;Jones et al, 2007;Onal et al, 2007;Rose et al, 2008a;Rose et al, 2008b;Dirani et al, 2009;Deng et al, 2010;Donovan et al, 2012;Fujiwara et al, 2012;Guggenheim et al, 2012;Cui et al, 2013;French et al, 2013cFrench et al, , 2013bGuo et al, 2013a;Wu et al, 2013;Gwiazda et al, 2014;Read et al, 2014;He et al, 2015) and eye growth during childhood. The relatively consistent findings from studies of a range of pediatric populations across different geographic locations, demonstrating an association between more outdoor activity and less prevalence (Parssinen & Lyyra, 1993;Mutti et al, 2002;Onal et al, 2007;Rose et al, 2008a;Rose et al, 2008b;Dirani et al, 2009;Deng et al, 2010;Donovan et al, 2012;Fujiwara et al, 2012;Guggenheim et al, 2012;Cui et al, 2013;French et al, 2013cFrench et al, , 2013bGuo et al, 2013a;Wu et al, 2013;Read et al, 2014;He et al, 2015) and incidence (Parssine...…”

Section: Hypothesismentioning

confidence: 99%

“…In human studies (including cross sectional, longitudinal, and interventional studies), greater time spent outdoors in childhood has been found to protect against the development of myopia, which also supports a role for ambient light exposure in refractive error development in the human eye, since spending time outdoors typically involves increased exposure to bright ambient light (Parssinen & Lyyra, 1993;Mutti et al, 2002;Jones et al, 2007;Onal et al, 2007;Rose et al, 2008a;Rose et al, 2008b;Dirani et al, 2009;Deng et al, 2010;Donovan et al, 2012;Guggenheim et al, 2012;Cui et al, 2013;French et al, 2013cFrench et al, , 2013bGuo et al, 2013a;Wu et al, 2013;Gwiazda et al, 2014;Read et al, 2014;He et al, 2015;Read et al, 2015). A recent longitudinal study of Australian school children utilising objective measures of personal ambient light exposure showed that greater daily light exposure was associated with slower axial eye growth over an 18-month period .…”

mentioning

confidence: 91%

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The Influence of Light Exposure and Seasonal Changes on Short-Term and Longer-Term Changes in Axial Length of the Human Eye

Ulaganathan¹

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It is widely accepted that environmental factors play a significant role in regulating eye growth and myopia development. There is also considerable evidence that ambient light exposure is an important environmental risk factor associated with eye growth in children, however, the underlying mechanism remains unclear. Furthermore, animal studies have shown that diurnal variations in ocular components appear to be involved in the mechanisms controlling eye growth. Animal studies also suggest that altering light exposure disrupts normal diurnal variations and can lead to the development of refractive errors. Despite this evidence, the exact role of light exposure and ocular diurnal rhythms in the regulation of human eye growth, and the interaction between these factors is not well understood. Myopia development and progression have been widely documented in young adults and typically occurs due to axial elongation, but there has been limited research examining the potential impact of ambient light exposure upon eye growth and myopia development and progression in young adults.Therefore, this research examined the habitual light exposure patterns in a population of young adult emmetropes and progressing myopes using objective techniques, and assessed the influence of light exposure upon daily axial length variations and longitudinal axial eye growth in this population. The potential association between daily axial length fluctuations and longer-term changes in axial length was also explored.Since there is no consensus on the optimal sampling strategy required for capturing personal objective light exposure measurements, in the first study, we systematically examined the impact of different measurement durations and measurement frequencies upon objective light exposure measures, in order to determine the optimal sampling strategy to reliably capture habitual light exposure patterns of both children (Age: 11 to vi The influence of light exposure and seasons upon the axial length changes in humans 15 years) and young adults (Age: 18 to 30 years). Ambient light exposure data were obtained using a wrist-worn light sensor (Actiwatch 2), which was configured to measure instantaneous light levels every 30 seconds, 24 hours a day for a period of 14 consecutive days in children (n = 30) and young adults (n = 31). Daily time exposed to bright outdoor (>1000 lux) light levels was derived from the raw 14 days of data with 30 second sampling, and was subsequently derived from data re-sampled from 12, 10, 8, 6, 4 and 2 randomly selected measurement days using 1, 2, 3, 4, 5 and 10 minute sampling rates. Calculating daily outdoor light exposure time using a lower number of days and coarser sampling frequencies did not significantly alter the mean time spent in bright (outdoor) light. However, a significant increase in measurement variability occurred for outdoor light exposure derived from less than 8 days and from 3 minutes or coarser measurement frequencies in adults, and from less than 8 days and from 4 minutes or coarser...

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Urban Living Environment and Myopia in Children

Li,

Qin

et al. 2023

JAMA Netw Open

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ImportanceThe global prevalence of myopia has shown a steady increase over recent decades, with urban areas seemingly experiencing a more significant impact.ObjectiveTo assess the association between urbanization and the prevalence, incidence, progression, and severity of myopia.Design, Setting, and ParticipantsThis cohort study included students in grades 1 to 6 in Tianjin, China, who underwent 3 vision examinations conducted over a 2-year period, from March 1, 2021, to March 31, 2023. Participants from grades 1 to 4 completed the 2-year follow-up.ExposuresUrban living environmentMain Outcomes and MeasuresThe association of urbanization with the incidence, progression, prevalence, and severity of myopia. To quantify urbanization, an urban score was constructed using satellite data and an iterative exploratory factor analysis.ResultsOf 177 894 students (51.7% male; mean [SD] age, 10.27 [1.75] years) included in the study, 137 087 students (52.3% male; mean [SD] age, 8.97 [1.21] years) were followed up for 2 years. A positive association was identified between myopia incidence and urbanization. Specifically, each 1-unit increment in the urban score was associated with an increased risk of myopia over a 1-year period (odds ratio [OR], 1.09; 95% CI, 1.01-1.15; P = .02) and a 2-year period (OR, 1.53; 95% CI, 1.50-1.57; P &lt; .001). Conversely, each 1-unit increase in the urban score was associated with a significant decrease in myopia progression at 1 year (OR, 0.84; 95% CI, 0.82-0.86; P &lt; .001) and 2 years (OR, 0.73; 95% CI, 0.70-0.75, P &lt; .001). In a cross-sectional data analysis, the urban score was positively associated with myopia prevalence (OR, 1.62; 95% CI, 1.08-2.42; P = .02) and negatively associated with myopia severity, as indicated by spherical equivalent refraction (OR, 1.46; 95% CI, 1.07-1.99; P = .02).Conclusions and RelevanceThis study exploring urban living environments and myopia revealed dual associations of urban living with both the incidence and the progression of myopia. The observed patterns emphasize the urgency of promptly implementing myopia control strategies in less urbanized regions, where myopia progression may be accentuated.

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Outdoor Activity and Myopia among Primary Students in Rural and Urban Regions of Beijing

Cited by 205 publications

References 32 publications

Practical applications to modify and control the development of ametropia

Practical applications to modify and control the development of ametropia

The Influence of Light Exposure and Seasonal Changes on Short-Term and Longer-Term Changes in Axial Length of the Human Eye

Urban Living Environment and Myopia in Children

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