The importance of daylight for myopia management in children

Myopia, or nearsightedness, is all too common. Myopia prevalence is increasing, and we expect it will affect half the global population by 2050.¹ It occurs when the eye grows too fast and becomes too long relative to the focusing power of the cornea and lens of the eye. This causes light rays to focus in front of the retina instead of on it, causing distant objects to appear blurry.

Myopia is often hereditary. Increased screen time and spending less time outdoors are also risk factors for myopia development and progression. That’s why it’s recommended for children, whose eyes are developing and who spend much more time indoors on devices these days, to balance screen time with outdoor time. This may help prevent myopia onset and slow its progression.

The link between daylight and myopia

From different studies, as summarized in the white papers from the International Myopia Institute (IMI), it has been confirmed that outdoor time in daylight has a preventive effect on the onset of myopia and potentially reduces the progression of myopia in children.² Outdoor light intensity increases one’s depth of focus and releases dopamine, which slows the axial elongation that causes myopia.

Experts recommend that children stay outdoors in daylight for at least 80 minutes a day.³ They also mentioned that every 45 minutes additionally spent outdoors can prevent 20% of the onset of myopia.

Outdoor light vs. indoor light

The difference in light between indoors and outdoors has to do with light intensity, spectral composition, temporal frequency, and time and place itself. The light intensity outdoors, even under a cloudy sky or in the shade, is more intensive than in an indoor situation.

The experts report that even with sunglasses, children will still be exposed to more intense light outdoors than indoors and still have the positive effect of daylight for myopia management and control.

Benefits of daylight and myopia management

The number one benefit of outdoor light and proven myopia control methods is that they can have a preventive effect on the onset of myopia and possibly reduce the progression.

Other benefits of daylight in myopia management:

• Increasing exposure to beneficial wavelengths of light
• Increased dopamine slows the growth of the eye
• Reduced screen time
• More evenly stimulated field of vision
• Stronger differentiation between contrast levels
• Lower risk for other myopia-induced conditions
• More physical activity for overall physical health

Tips for parents to get their kids outdoors

Encourage your patients who are parents to start eye exams early and to get creative when it comes to getting their kids outdoors. A child can get their first eye exam as early as 6 months old.

Here are some suggestions you can make.

• Restrict children’s screen time/use of technology each day
• Schedule outdoor activities together as a family
• Park a few minutes from school and walk together
• Let the kids use a phone to record the world around them
• Attend local outdoor events, like musicals or plays
• Visit places where animals are the center of attention
• Take up gardening as a recurring family activity

Keep UV exposure and protection in mind

As an ECP, you want your patients’ children to get outdoors to lower their risk of myopia. At the same time, they need to be equally aware of the importance of UV protection.

UV (ultraviolet) rays can cause potential damage to the eye structures, and intense daylight can cause glare and reduce visual performance. UV light can also damage the outside of the eyes and the surrounding skin, as the area around the eyes is often exposed and difficult to protect with items like sunscreen.

When undergoing myopia management, it’s recommended to wear 100% UV protection. Fortunately, at present, there is no evidence that UV protection will influence the effectiveness of optical myopia management options.

With HOYA’s MiYOSMART sun spectacle lenses, we’re able to slow down the progression of myopia and protect the eyes from intense UV light.

Myopia management strategies

Myopia is not curable, but it is treatable. The target of myopia treatment is to slow its progression and correct the blurred far vision through the best-determined myopia management solution. The best course of treatment should be decided by the parents, the child, and the optometrist.

MiYOSMART

Myopia management includes an early identification/diagnosis of myopia and a development of a treatment plan which could include wearing the MiYOSMART spectacle lens that is clinically proven over 6 years to slow the progression of myopia in children age 8-13 by an average of 60%.⁴

Atropine eye drops

In contrast to previous years when atropine was prescribed as a first-line treatment by ophthalmologists, many eye care professionals now start prescribing MiYOSMART spectacle lenses as initial treatment.

Orthokeratology

Other treatment modalities to manage myopia include orthokeratology, which is the use of custom-fitted contact lenses to temporarily reshape the cornea and improve vision.

Combination treatment + outdoors

If the expected treatment goal is not achieved only with MiYOSMART spectacle lens, experts noted a better control effect in combination treatment with atropine. In case of usage of high-dose atropine with accommodative insufficiency, the experts recommend using accommodative support spectacle lens designs.

Combined with regular check-ups and natural methods, such as reduced screen time and more time outdoors, there’s hope for effective myopia control.

Quick fact: Regular single vision lenses simply correct refractive errors but do not slow down the progression of myopia, so lenses like MiYOSMART are key to managing myopia.

Getting kids outside and often

Start the conversation early with parents. Guide them as their local ECP and give them the information they need to prevent and slow the progression of one of the most common eye conditions among children today.

¹ Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050 Holden, Brien A. et al. Ophthalmology, Volume 123, Issue 5, 1036 – 104.

² Wolffsohn JS, et al., IMI 2021 Reports and Digest – Reflections on the Implications for Clinical Practice. Invest. Ophthalmol. Vis. Sci. 2021;62(5):1. doi: https://doi.org/10.1167/iovs.62.5.1.

³ Jonas JB, Ang M, Cho P, et al. IMI prevention of myopia and its progression. Invest Ophthalmol Vis Sci. 2021;62(5):6. https://doi.org/10.1167/iovs.62.5.6Morgan IG, Wu P-C, Ostrin LA, et al. IMI Risk factors for myopia. Invest Ophthalmol Vis Sci. 2021;62(5):3.
https://doi.org/10.1167/iovs.62.5.3

⁴ Lam CSY,  Tang, WC, Zhang, HY et al. Long-term myopia control effect and safety in children wearing DIMS spectacle lenses for 6 years. Sci Rep 12, 5475 (2023). https://doi.org/10.1038/s41598-023-32700-7