Myopia in children: why time outdoors matters
Short-sightedness is becoming more common in children. What a large school trial found about outdoor time, and simple ways to fit more of it into the week.
Ocufuse teamMyopia, or short-sightedness, means distant things look blurry while close things are clear. It's very common, and it's becoming more so. The American Academy of Ophthalmology reports that about 40 percent of children aged 6 to 19 are nearsighted, with rates in Asia nearly double that.
One of the most studied everyday factors is how much time children spend outdoors.
What a school trial found
A large trial in Guangzhou, China, published in JAMA in 2015, tested whether extra outdoor time at school made a difference.
- Who took part. 1,903 first-grade children, average age 6.6, in 12 primary schools.
- What changed. Six schools added one extra 40-minute outdoor activity class each school day, and parents were encouraged to take children outdoors after school and at weekends. The other six schools carried on as usual.
- What happened. Over three years, 30.4 percent of children in the outdoor schools developed myopia, compared with 39.5 percent in the comparison schools.
The researchers concluded that extra outdoor time reduced how many children developed myopia over three years. They also noted that longer follow-up, and studies in other settings, were needed. Outdoor time lowered the number of new cases in this group. It didn't prevent myopia in every child, and it isn't a treatment for myopia that has already started.
What the AAO suggests
An AAO article on childhood myopia shares a pediatric ophthalmologist's advice:
- Aim for at least one to two hours outdoors each day
- Limit recreational screen time to one to two hours a day
- Take regular breaks from close work, using the 20-20-20 rule
The same article notes that a national study found only half of parents understand that screen time can affect their child's eye health. It also points out that myopia starting earlier in childhood is more likely to become more severe later.
Ways to fit in more outdoor time
The pediatric ophthalmologist quoted by the AAO says you don't have to radically change your life. Small, regular habits add up:
- Walk or cycle to school when it's safe
- Move reading, homework or snacks outside on fine days
- Plan weekend activities in parks, gardens or playgrounds
- Swap some indoor screen time for outdoor play
- Build in short outdoor breaks during long study sessions
Follow your local advice on sun protection while outdoors, such as hats and shade during the strongest sun. Our post on sunglasses and UV covers eye protection for children.
Signs a child may not be seeing clearly
Children often don't realise their vision is blurry, because it's all they know. Things to watch for:
- Squinting to see things far away
- Sitting very close to the TV or holding devices close
- Trouble seeing the board at school
- Rubbing their eyes a lot, or complaining of headaches or tired eyes
Treatment is a conversation for a professional
The AAO mentions that some treatments, such as certain eye drops and specially fitted contact lenses, can slow myopia progression in children. Whether any of these suit your child, and how they're used, is a decision for an optometrist or ophthalmologist after an examination. Don't buy products marketed for myopia control without professional advice.
When to see someone
Book an eye test with an optometrist or your child's doctor if:
- You notice any of the signs above
- A school vision screening suggests a follow-up
- Your child already wears glasses and seems to be struggling again
- There is short-sightedness in the family and your child hasn't had an eye test