Last Updated: March 28, 2023
Children spend less time playing outdoors than ever before, which results in less exposure to nature and sunlight. Less time outdoors, prolonged near work and increased screen use has been linked to elevated risks of developing myopia (nearsightedness) in children.1,2 Currently, myopia affects 30% of the population and it is increasing at an alarming rate, estimated to rise to 50% by 2050.3 In addition to the increased prevalence, myopia is also occurring in earlier ages and progressing more rapidly than the previous generations.4 This is a significant public health concern, as high levels of myopia can lead to sight-threatening conditions including retinal detachments, cataracts, glaucoma and myopic maculopathy.5
Studies have shown that increased outdoor time have a protective effect against the onset of myopia and help to prevent myopia in children.6,7 Remember to wear sunglasses while outdoors to protect the eyes from the harmful UV rays of the sun. The protective benefit of outdoor light is preserved even with sunglasses wear.
An increase of 1 hour per day of outdoor time results in a 45% reduction in the occurrence of myopia in children.6,8
The use of digital devices is exploding everywhere, in the workplace, social culture and virtual schooling. Although these devices are beneficial to our lives it many ways, there are risks associated with it as well, such as an elevated risk for developing myopia in children.2 In addition, 2-year-old infants with increased screen time (2 hours a day) showed poorer performance on developmental screening later in life, including a decrease in motor, vocabulary and communication skills.9 Other studies have shown that children with more than 2 hours of screen time a day has an increased risk of developing ADHD.10,11 Moreover, exposure to screen-time particularly during the evening hours leads to sleep and cognitive performance problems.12
To protect your child’s vision and eye health, it is important to balance different types of activities between near work (ex. reading), digital device use (ex. playing games), and outdoor time. Participating in activities like walking, hiking, cycling, swimming, skiing, various sports and other outdoor activities can help preserve healthy eyes in children.
Recommendations to counter myopia (nearsightedness) in children
- Encourage children to play outside for 1 hour per day, more is better
- Screen time recommendation for children, less is better
- For 0-2 years old children, screen time is not recommended (occasional video calling is permissible)
- For preschooler-age children, screen time of no more than 1 hour at a time with regular breaks is recommended
- For school-age children, screen time with regular breaks is crucial, recommended break schedule is based on the 20-20-20 rule
- Use blue light blocking software on digital devices or blue-light blocking glasses to help with your child’s sleep, avoid screen time before going to beed
- Get routine eye exams from the optometrist
- First eye exam when infants is 6-9 months old
- Second eye exam when the child is 2-5 years old
- Yearly eye exams when the child is school aged from 6-19 years old
- Mutti DO et al. Parental myopia, near work, school achievement, and children’s refractive error. Invest Ophthalmol Vis Sci. 2002;43(12):3633-3640.
- Foreman J et al. Association between digital smart device use and myopia: a systematic review and meta-analysis. Lancet. 2021;3(12):e806-e818.
- Holden BA et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmol. 2016;123(5):1036-1042.
- Vitale S et al. Increased prevalence of myopia in the United States between 1971-1972 and 1999-2004. Arch Ophthalmol. 2009;127(12):1632-1639.
- Filtcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Prog Retin Eye Res. 2012:31(6):622-660.
- Xiong et al. Time spent in outdoor activities in relation to myopia prevention and control: a meta-analysis and systemic review. Acta Ophthalmol. 2017;95(6):551-566.
- Guo Y et al. Outdoor jogging and myopia progression in school children from rural Beijing: the Beijing children eye study. Transl Vis Sci Technol. 2019;8(2):2-2.
- Yang M et al. Myopia prevalence in Canadian school children: a pilot study. Eye. 2018;32(2):1042-1047.
- Madigan S et al. Association between screen time and children’s performance on a developmental screening test. JAMA Pediatr. 2019;173(3):244-250.
- Tamana et al. Screen-time is associated with inattention problems in preschoolers: results from the CHILD birth cohort study. PLoS ONE. 2019;14(4):e0213995.
- Chaelin KR et al. Association of digital media use with subsequent symptoms of attention-deficit/hyperactivity disorder among adolescents. JAMA. 2018;320(3):255-263.
- Cajochen C et al. Evening exposure to a light-emitting diodes (LED)-backlit computer screen affects circadian physiology and cognitive performance. J Appl Physiol. 2011.