Association Between Outdoor Activity and Myopia Progression

Abstract

Background: Myopia is a refractive defect that is on a rising trend of prevalence in children and adolescents all over the world. Poor environmental conditions especially less outdoor activities and more exposure to near work have been associated with the speed up of myopia. There is dearth of local information on this association in Pakistani children.

Objective: To identify the relationship between outdoor activity and the development of myopia among school-aged children who visit a tertiary care hospital in DI Khan, Pakistan.

Methods: The present analytical cross-sectional study was carried out in the Department of Ophthalmology Gomal Medical College, Dera Ismail Khan, from July 2022 to June 2023. One hundred eighty myopic children aged between 6 and 15 years were recruited by non-probability consecutive sampling. A structured proforma was to gather information on the data on daily outdoor activity, near-work duration, and family history. Spherical equivalent was determined by carrying out cycloplegic refraction. The progression of myopia was considered an improvement of 0.50 or more diopters in 12 months. The SPSS version 26 was employed to analyze data. Associations were evaluated using chi-square test and p 0.05 was taken as statistically significant.

Results: The age of the subjects was 10.8 ± 2.4 years, 54.4% of the males and 45.6% of the females. The development of myopia was found in 73 (40.6) children. Rates of progression were greatest with children who were spending less than 1 hour/day outside (63.3) and lowest with children who were spending more than 2 hours/day outside (20.0) (p = 0.001). No meaningful results were also observed between myopia progression and positive family history (p = 0.018) and high near-work exposure (>3 hours/day) (p = 0.004).

Conclusion: Lack of outdoor exercise is closely linked to the development of myopia among school-going children. Outdoor exposure could be promoted as a simple low-cost intervention in order to decrease the problem of progressive myopia among the pediatric population of DI Khan.

Keywords: Myopia; Exercise; Near work; Pediatric ophthalmology; Near work; Refractive error; Pakistan.