Spending more time outdoors may prevent myopia in children

Spending more time outdoors may prevent myopia in children

Vanessa Jordan
PEARLS No.
750
Clinical question

Can increasing the time spent outdoors reduce the incidence and progression of myopia in children?

Bottom line

The results of this review suggest that long-term interventions to increase the time spent outdoors may reduce the development of myopia in children. These interventions may also reduce the progression of myopia (as assessed by changes in refractive errors and axial lengths), but the low certainty of the evidence makes it difficult to draw conclusions.

The majority of the trials were cluster randomised and school based. The interventions included classroom time outdoors, routine for spending recess outdoors, motivational tools for spending time outdoors, and encouragement through messages via electronic media.

Caveat

Most of the included participants were young school children in their first few years of education (aged six to nine years), so it is unclear whether the results are applicable to children younger or older than this. In addition, all the included studies were based in Asia, which has the highest prevalence of myopia in the world. It is unknown if these results are generalisable to countries outside of Asia.

Context

Myopia, or nearsightedness, is a major global health problem. Observational studies indicate that children who spend more time outdoors have a lower incidence of myopia. However, existing systematic reviews on this topic include various study designs, not exclusively randomised controlled trials, which limits the strength of their conclusions.

This review was designed to help standardise findings, enhance generalisability and inform evidence-based strategies to prevent and manage myopia more effectively.

Cochrane Systematic Review

Kido A, et al. Interventions to increase time spent outdoors for preventing incidence and progression of myopia in children. Cochrane Database Syst Rev 2024;6:CD013549. This review contains 5 trials, and 10,733 people.