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Is It Possible to Prevent Nearsightedness in Children?

Children spending time outside (more than 14 hours a week) have lower rates of nearsightedness, even if they spend a lot of time reading. From Science Daily:

Scientists study effects of sunlight to reduce number of nearsighted kids

Kids who spend more time outside are less likely to need glasses for nearsightedness – but scientists don’t know why. Researchers are now looking more closely at physical changes in the eye influenced by outdoor light exposure in the hopes of reducing cases of myopia, which affects one-third of the American population.

Despite what many parents may think, kids who spend a lot of time reading or squinting at tiny electronic screens aren't more likely to become nearsighted than kids who don't. However, that risk is only reduced if the child spends plenty of quality time outside. The "outdoor effect" on nearsightedness, or myopia, is a longstanding observation backed by both scientific and anecdotal evidence. It's so compelling that some nations in Asia, which have among the highest myopia rates in the world, have increased the amount of daily outdoor time for children in the hopes of reducing the need for glasses.

But so far, no one has defined exactly what it is about being outside that seems to offer a protective effect against the condition, which causes distant objects to appear blurry.

"Data suggest that a child who is genetically predisposed to myopia are three times less likely to need glasses if they spend more than 14 hours a week outdoors," says optometrist Donald Mutti, OD, PhD, of The Ohio State University College of Optometry. "But we don't really know what makes outdoor time so special. If we knew, we could change how we approach myopia."

Supported by a pilot grant from Ohio State's Center for Clinical and Translational Science (CCTS), Mutti is now focusing his research on the variables he feels have the most potential: invisible ultraviolet B rays (UVB) and vitamin D, and visible bright light and dopamine."Between the ages of five and nine, a child's eye is still growing. Sometimes this growth causes the distance between the lens and retina to lengthen, leading to nearsightedness," explained Mutti. "We think these different types of outdoor light may help preserve the proper shape and length of the eye during that growth period."

UVB light is invisible to the human eye, but triggers several cellular functions in the body, including the production of vitamin D. Vitamin D is thought to support the function of the smooth muscle tissue found around the lens in the eye. This muscle not only helps focus light on the retina, but may also maintain the proper eye shape and length between the lens and the retina, something that can become distorted during the rapid growth of a child's eye.

Some studies, including one by Mutti, show that people with myopia have lower blood levels of vitamin D -- indicating that they have spent less time outdoors, with possible negative effects on the eye..."We don't know if vitamin D is simply a proxy for measuring outdoor time, or if it is actually exerting a biological effect on how the eye works and develops," said Mutti.

There's another part of sunlight that could help prevent myopia: exposure to visible bright light. Even on a cloudy day, visible light outdoors is at least 10 times brighter than the light indoors.When exposed to outdoor light, specialized cells in the retina help control how big or little the pupil dilates to let more or less light in. The cells connect to others that release dopamine -- an important neurotransmitter in the eye and brain. Previous research suggests that dopamine also slows down the growth of the eye, but there isn't technology currently available that can measure dopamine release in the eye directly.