Outdoors Activity as A Protective Factor of Myopia Incidence in Children
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Submitted
April 26, 2016
Published
April 27, 2016
Abstract
Background: Outdoors activities emerge as one of protective factors in myopia incidence and progression. The aim of this literature review is to evaluate the effect of outdoor activity on preventionof myopia incidence in children age 0 to 18 years old.
Methods: The literature search was conducted from MEDLINE database using Pubmed for journalarticles that were published and related to the association between outdoor activity and incidence ofmyopia, guided by MOOSE checklist. Random effect meta-analysis is done on 1 hour/week outdooractivity and incidence of myopia.
Results: Thirteen studies were reviewed, 8 of which are cross-sectional studies and 5 of which arecohort studies. Random effect meta-analysis showed OR of 0.9 (CI 95% 0.59-1.55).
Conclusion: Outdoor activity as protective factor in preventing incidence of myopia is still inconclusive.However, throughout most articles reviewed in this literature, there is a trend towards its protectiveeffect in preventing myopia incidence.
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References
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2. French AN, Morgan IG, Mitchell P, Rose KA. Risk factors for incident myopia in Australian schoolchildren: the Sydney adolescent vascular and eye study. Ophthalmology 2013;120:2100-8.
3. Barliana J, Mangunkusumo V, Rahayu T. Sebaran dan faktor resiko myopia pada siswa kelas tiga dan enam di SDN percontohan menteng 01 Jakarta dan SDN Harjamukti 3-4 Cimanggis Depok. Jakarta: Fakultas Kedokteran Universitas Indonesia; 2004.
4. Nasrudin, Rahayu T. Karakteristik kelainan refraksi pada siswa SDN di Jakarta. Jakarta: Fakultas Kedokteran Universitas Indonesia; 2006.
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6. Morgan IG, Ohno-Matsui K, Saw SM. Myopia. Lancet 2012;379:1739-48.
7. Ip JM, Saw SM, Rose KA, et al. Role of near work in myopia: findings in a sample of Australian school children. Investigative Ophthalmology & Visual Science 2008;49:2903-10.
8. Jones-Jordan LA, Sinnott LT, Graham ND, et al. The Contributions of Near Work and Outdoor Activity to the Correlation Between Siblings in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study. Investigative Ophthalmology & Visual Science 2014;55:6333-9.
9. Low W, Dirani M, Gazzard G, et al. Family history, near work, outdoor activity, and myopia in Singapore Chinese preschool children. The British Journal of Ophthalmology 2010;94:1012-6.
10. Lu B, Congdon N, Liu X, et al. Associations between near work, outdoor activity, and myopia among adolescent students in rural China: the Xichang Pediatric Refractive Error Study report no. 2. Archives of Ophthalmology 2009;127:769-75.
11. Mutti DO, Mitchell GL, Moeschberger ML, Jones LA, Zadnik K. Parental myopia, near work, school achievement, and children’s refractive error. Investigative Ophthalmology & Visual Science 2002;43:3633-40.
12. Ciuffreda KJ, Vasudevan B. Effect of nearwork-induced transient myopia on distance retinal defocus patterns. Optometry 2010;81:153-6.
13. Guo Y, Liu LJ, Xu L, et al. Outdoor activity and myopia among primary students in rural and urban regions of Beijing. Ophthalmology 2013;120:277-83.
14. Ip JM, Rose KA, Morgan IG, Burlutsky G, Mitchell P. Myopia and the urban environment: findings in a sample of 12-year-old Australian school children. Investigative Ophthalmology & Visual Science 2008;49:3858-63.
15. Mirshahi A, Ponto KA, Hoehn R, et al. Myopia and level of education: results from the gutenberg health study. Ophthalmology 2014;121:2047-52.
16. Morgan IG, Rose KA. Myopia and international educational performance. Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians 2013;33:329-38.
17. Xu L, Wang Y, Wang S, Wang Y, Jonas JB. High myopia and glaucoma susceptibility the Beijing Eye Study. Ophthalmology 2007;114:216-20.
18. Deng L, Gwiazda J, Thorn F. Children’s refractions and visual activities in the school year and summer. Optometry and vision science : official publication of the American Academy of Optometry 2010;87:406-13.
19. Rose KA, Morgan IG, Ip J, et al. Outdoor activity reduces the prevalence of myopia in children. Ophthalmology 2008;115:1279-85.
20. Dirani M, Tong L, Gazzard G, et al. Outdoor activity and myopia in Singapore teenage children. The British Journal of Ophthalmology 2009;93:997-1000.
21. Jones LA, Sinnott LT, Mutti DO, Mitchell GL, Moeschberger ML, Zadnik K. Parental history of myopia, sports and outdoor activities, and future myopia. Investigative Ophthalmology & Visual Science 2007;48:3524-32.
22. McKnight CM, Sherwin JC, Yazar S, et al. Myopia in Young Adults Is Inversely Related to an Objective Marker of Ocular Sun Exposure: The Western Australian Raine Cohort Study. American Journal of Ophthalmology 2014.
23. Mutti DO, Marks AR. Blood levels of vitamin D in teens and young adults with myopia. Optometry and vision science: official publication of the American Academy of Optometry 2011;88:377-82.
24. Wu PC, Tsai CL, Wu HL, Yang YH, Kuo HK. Outdoor activity during class recess reduces myopia onset and progression in school children. Ophthalmology 2013;120:1080-5.
25. Rose KA, Morgan IG, Smith W, Burlutsky G, Mitchell P, Saw SM. Myopia, lifestyle, and schooling in students of Chinese ethnicity in Singapore and Sydney. Archives of Ophthalmology 2008;126:527-30.
26. Lin HJ, Wan L, Tsai FJ, et al. Overnight orthokeratology is comparable with atropine in controlling myopia. BMC Ophthalmology 2014;14:40.
27. Leo SW, Young TL. An evidence-based update on myopia and interventions to retard its progression. Journal of AAPOS: the official publication of the American Association for Pediatric Ophthalmology and Strabismus/ American Association for Pediatric Ophthalmology and Strabismus 2011;15:181-9.
28. Galvis V, Tello A, Rodriguez CJ, Rey JJ. Atropine dose to treat myopia. Ophthalmology 2012;119:1718; author reply -9.
29. Chia A, Chua WH, Wen L, Fong A, Goon YY, Tan D. Atropine for the treatment of childhood myopia: changes after stopping atropine 0.01%, 0.1% and 0.5%. American Journal of Ophthalmology 2014;157:451-7 e1.
30. Chua WH, Balakrishnan V, Chan YH, et al. Atropine for the treatment of childhood myopia. Ophthalmology 2006;113:2285-91.
31. Fang YT, Chou YJ, Pu C, et al. Prescription of atropine eye drops among children diagnosed with myopia in Taiwan from 2000 to 2007: a nationwide study. Eye 2013;27:418-24.
32. Wu PC, Yang YH, Fang PC. The long-term results of using low-concentration atropine eye drops for controlling myopia progression in schoolchildren. Journal of ocular pharmacology and therapeutics: the Official Journal of the Association for Ocular Pharmacology and Therapeutics 2011;27:461-6.
33. Hornbeak DM, Young TL. Myopia genetics: a review of current research and emerging trends. Current Opinion in Ophthalmology 2009;20:356-62.
34. Howick J, Chalmers I, Glasziou P, et al. The Oxford 2011 Level of Evidence (Introductory Document). Oxford Centre for Evidence-Based Medicine; 2011.
35. Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. Jama 2000;283:2008-12.
36. Saw SM, Shankar A, Tan SB, et al. A cohort study of incident myopia in Singaporean children. Investigative Ophthalmology & Visual Science 2006;47:1839-44.
37. Khader YS, Batayha WQ, Abdul-Aziz SM, Al-ShiekhKhalil MI. Prevalence and risk indicators of myopia among schoolchildren in Amman, Jordan. Eastern Mediterranean Health Journal = La Revue de Sante de La Mediterranee Orientale = al-Majallah al-Sihhiyah li-Sharq al-Mutawassit 2006;12:434-9.
38. Wu PC, Tsai CL, Hu CH, Yang YH. Effects of outdoor activities on myopia among rural school children in Taiwan. Ophthalmic epidemiology 2010;17:338-42.
39. Jones-Jordan LA, Mitchell GL, Cotter SA, et al. Visual activity before and after the onset of juvenile myopia. Investigative Ophthalmology & Visual Science 2011;52:1841-50.
40. French AN, Ashby RS, Morgan IG, Rose KA. Time outdoors and the prevention of myopia. Experimental Eye Research 2013;114:58-68.
41. Sherwin JC, Reacher MH, Keogh RH, Khawaja AP, Mackey DA, Foster PJ. The association between time spent outdoors
and myopia in children and adolescents: a systematic review and meta-analysis. Ophthalmology 2012;119:2141-51.
42. Cui D, Trier K, Munk Ribel-Madsen S. Effect of day length on eye growth, myopia progression, and change of corneal power in myopic children. Ophthalmology 2013;120:1074-9.
43. Sherwin JC, Hewitt AW, Kearns LS, Coroneo MT, Griffiths LR, Mackey DA. Distribution of conjunctival ultraviolet autofluorescence in a population-based study: the Norfolk Island Eye Study. Eye 2011;25:893-900.
44. Ashby R, Ohlendorf A, Schaeffel F. The effect of ambient illuminance on the development of deprivation myopia in chicks. Investigative Ophthalmology & Visual Science 2009;50:5348-54.
45. Schmid KL, Leyden K, Chiu YH, et al. Assessment of daily light and ultraviolet exposure in young adults. Optometry and vision science: official publication of the American Academy of Optometry 2013;90:148-55.
2. French AN, Morgan IG, Mitchell P, Rose KA. Risk factors for incident myopia in Australian schoolchildren: the Sydney adolescent vascular and eye study. Ophthalmology 2013;120:2100-8.
3. Barliana J, Mangunkusumo V, Rahayu T. Sebaran dan faktor resiko myopia pada siswa kelas tiga dan enam di SDN percontohan menteng 01 Jakarta dan SDN Harjamukti 3-4 Cimanggis Depok. Jakarta: Fakultas Kedokteran Universitas Indonesia; 2004.
4. Nasrudin, Rahayu T. Karakteristik kelainan refraksi pada siswa SDN di Jakarta. Jakarta: Fakultas Kedokteran Universitas Indonesia; 2006.
5. Sari D, Sitorus R, Rahayu T, Barliana J. Pengaruh lamanya aktivitas di luar rumah dan aktivitas melihat dekat terhadap prevalensi miopia pada anak sekolah dasar di Kabupaten Tangerang. Jakarta: Fakultas Kedokteran Universitas Indonesia; 2010.
6. Morgan IG, Ohno-Matsui K, Saw SM. Myopia. Lancet 2012;379:1739-48.
7. Ip JM, Saw SM, Rose KA, et al. Role of near work in myopia: findings in a sample of Australian school children. Investigative Ophthalmology & Visual Science 2008;49:2903-10.
8. Jones-Jordan LA, Sinnott LT, Graham ND, et al. The Contributions of Near Work and Outdoor Activity to the Correlation Between Siblings in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study. Investigative Ophthalmology & Visual Science 2014;55:6333-9.
9. Low W, Dirani M, Gazzard G, et al. Family history, near work, outdoor activity, and myopia in Singapore Chinese preschool children. The British Journal of Ophthalmology 2010;94:1012-6.
10. Lu B, Congdon N, Liu X, et al. Associations between near work, outdoor activity, and myopia among adolescent students in rural China: the Xichang Pediatric Refractive Error Study report no. 2. Archives of Ophthalmology 2009;127:769-75.
11. Mutti DO, Mitchell GL, Moeschberger ML, Jones LA, Zadnik K. Parental myopia, near work, school achievement, and children’s refractive error. Investigative Ophthalmology & Visual Science 2002;43:3633-40.
12. Ciuffreda KJ, Vasudevan B. Effect of nearwork-induced transient myopia on distance retinal defocus patterns. Optometry 2010;81:153-6.
13. Guo Y, Liu LJ, Xu L, et al. Outdoor activity and myopia among primary students in rural and urban regions of Beijing. Ophthalmology 2013;120:277-83.
14. Ip JM, Rose KA, Morgan IG, Burlutsky G, Mitchell P. Myopia and the urban environment: findings in a sample of 12-year-old Australian school children. Investigative Ophthalmology & Visual Science 2008;49:3858-63.
15. Mirshahi A, Ponto KA, Hoehn R, et al. Myopia and level of education: results from the gutenberg health study. Ophthalmology 2014;121:2047-52.
16. Morgan IG, Rose KA. Myopia and international educational performance. Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians 2013;33:329-38.
17. Xu L, Wang Y, Wang S, Wang Y, Jonas JB. High myopia and glaucoma susceptibility the Beijing Eye Study. Ophthalmology 2007;114:216-20.
18. Deng L, Gwiazda J, Thorn F. Children’s refractions and visual activities in the school year and summer. Optometry and vision science : official publication of the American Academy of Optometry 2010;87:406-13.
19. Rose KA, Morgan IG, Ip J, et al. Outdoor activity reduces the prevalence of myopia in children. Ophthalmology 2008;115:1279-85.
20. Dirani M, Tong L, Gazzard G, et al. Outdoor activity and myopia in Singapore teenage children. The British Journal of Ophthalmology 2009;93:997-1000.
21. Jones LA, Sinnott LT, Mutti DO, Mitchell GL, Moeschberger ML, Zadnik K. Parental history of myopia, sports and outdoor activities, and future myopia. Investigative Ophthalmology & Visual Science 2007;48:3524-32.
22. McKnight CM, Sherwin JC, Yazar S, et al. Myopia in Young Adults Is Inversely Related to an Objective Marker of Ocular Sun Exposure: The Western Australian Raine Cohort Study. American Journal of Ophthalmology 2014.
23. Mutti DO, Marks AR. Blood levels of vitamin D in teens and young adults with myopia. Optometry and vision science: official publication of the American Academy of Optometry 2011;88:377-82.
24. Wu PC, Tsai CL, Wu HL, Yang YH, Kuo HK. Outdoor activity during class recess reduces myopia onset and progression in school children. Ophthalmology 2013;120:1080-5.
25. Rose KA, Morgan IG, Smith W, Burlutsky G, Mitchell P, Saw SM. Myopia, lifestyle, and schooling in students of Chinese ethnicity in Singapore and Sydney. Archives of Ophthalmology 2008;126:527-30.
26. Lin HJ, Wan L, Tsai FJ, et al. Overnight orthokeratology is comparable with atropine in controlling myopia. BMC Ophthalmology 2014;14:40.
27. Leo SW, Young TL. An evidence-based update on myopia and interventions to retard its progression. Journal of AAPOS: the official publication of the American Association for Pediatric Ophthalmology and Strabismus/ American Association for Pediatric Ophthalmology and Strabismus 2011;15:181-9.
28. Galvis V, Tello A, Rodriguez CJ, Rey JJ. Atropine dose to treat myopia. Ophthalmology 2012;119:1718; author reply -9.
29. Chia A, Chua WH, Wen L, Fong A, Goon YY, Tan D. Atropine for the treatment of childhood myopia: changes after stopping atropine 0.01%, 0.1% and 0.5%. American Journal of Ophthalmology 2014;157:451-7 e1.
30. Chua WH, Balakrishnan V, Chan YH, et al. Atropine for the treatment of childhood myopia. Ophthalmology 2006;113:2285-91.
31. Fang YT, Chou YJ, Pu C, et al. Prescription of atropine eye drops among children diagnosed with myopia in Taiwan from 2000 to 2007: a nationwide study. Eye 2013;27:418-24.
32. Wu PC, Yang YH, Fang PC. The long-term results of using low-concentration atropine eye drops for controlling myopia progression in schoolchildren. Journal of ocular pharmacology and therapeutics: the Official Journal of the Association for Ocular Pharmacology and Therapeutics 2011;27:461-6.
33. Hornbeak DM, Young TL. Myopia genetics: a review of current research and emerging trends. Current Opinion in Ophthalmology 2009;20:356-62.
34. Howick J, Chalmers I, Glasziou P, et al. The Oxford 2011 Level of Evidence (Introductory Document). Oxford Centre for Evidence-Based Medicine; 2011.
35. Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. Jama 2000;283:2008-12.
36. Saw SM, Shankar A, Tan SB, et al. A cohort study of incident myopia in Singaporean children. Investigative Ophthalmology & Visual Science 2006;47:1839-44.
37. Khader YS, Batayha WQ, Abdul-Aziz SM, Al-ShiekhKhalil MI. Prevalence and risk indicators of myopia among schoolchildren in Amman, Jordan. Eastern Mediterranean Health Journal = La Revue de Sante de La Mediterranee Orientale = al-Majallah al-Sihhiyah li-Sharq al-Mutawassit 2006;12:434-9.
38. Wu PC, Tsai CL, Hu CH, Yang YH. Effects of outdoor activities on myopia among rural school children in Taiwan. Ophthalmic epidemiology 2010;17:338-42.
39. Jones-Jordan LA, Mitchell GL, Cotter SA, et al. Visual activity before and after the onset of juvenile myopia. Investigative Ophthalmology & Visual Science 2011;52:1841-50.
40. French AN, Ashby RS, Morgan IG, Rose KA. Time outdoors and the prevention of myopia. Experimental Eye Research 2013;114:58-68.
41. Sherwin JC, Reacher MH, Keogh RH, Khawaja AP, Mackey DA, Foster PJ. The association between time spent outdoors
and myopia in children and adolescents: a systematic review and meta-analysis. Ophthalmology 2012;119:2141-51.
42. Cui D, Trier K, Munk Ribel-Madsen S. Effect of day length on eye growth, myopia progression, and change of corneal power in myopic children. Ophthalmology 2013;120:1074-9.
43. Sherwin JC, Hewitt AW, Kearns LS, Coroneo MT, Griffiths LR, Mackey DA. Distribution of conjunctival ultraviolet autofluorescence in a population-based study: the Norfolk Island Eye Study. Eye 2011;25:893-900.
44. Ashby R, Ohlendorf A, Schaeffel F. The effect of ambient illuminance on the development of deprivation myopia in chicks. Investigative Ophthalmology & Visual Science 2009;50:5348-54.
45. Schmid KL, Leyden K, Chiu YH, et al. Assessment of daily light and ultraviolet exposure in young adults. Optometry and vision science: official publication of the American Academy of Optometry 2013;90:148-55.
Authors
Anandita, W., & Barliana, J. D. (2016). Outdoors Activity as A Protective Factor of Myopia Incidence in Children. Ophthalmologica Indonesiana, 41(3). https://doi.org/10.35749/journal.v41i3.42
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Anandita, W., & Barliana, J. D. (2016). Outdoors Activity as A Protective Factor of Myopia Incidence in Children. Ophthalmologica Indonesiana, 41(3). https://doi.org/10.35749/journal.v41i3.42