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Review
. 2022 Mar;70(3):728-739.
doi: 10.4103/ijo.IJO_1564_21.

Physical activity, time spent outdoors, and near work in relation to myopia prevalence, incidence, and progression: An overview of systematic reviews and meta-analyses

Siddharth K Karthikeyan  1 , D L Ashwini  2 , M Priyanka  3 , Anush Nayak  4 , Sayantan Biswas  5
Affiliations
Review

Physical activity, time spent outdoors, and near work in relation to myopia prevalence, incidence, and progression: An overview of systematic reviews and meta-analyses

Siddharth K Karthikeyan et al. Indian J Ophthalmol. 2022 Mar.

Abstract

Myopia has reached epidemic levels in recent years. Stopping the development and progression of myopia is critical, as high myopia is a major cause of blindness worldwide. This overview aims at finding the association of time spent outdoors (TSO), near work (NW), and physical activity (PA) with the incidence, prevalence, and progression of myopia in children. Literature search was conducted in PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature, Cochrane Database of Systematic Reviews, ProQuest, and Web of Science databases. Systematic reviews (SR) and meta-analyses (MA) on the TSO, NW, and PA in relation to myopia were reviewed. Methodological nature of qualified studies were evaluated utilizing the Risk of Bias in Systematic Review tool. We identified four SRs out of which three had MA, which included 62 unique studies, involving >1,00,000 children. This overview found a protective trend toward TSO with a pooled odds ratio (OR) of 0.982 (95% confidence interval (CI) 0.979-0.985, I2 = 93.5%, P < 0.001) per extra hour of TSO every week. A pooled OR 1.14 (95% CI 1.08-1.20) suggested NW to be related to risk of myopia. However, studies associating myopia with NW activities are not necessarily a causality as the effect of myopia might force children to indoor confinement with more NW and less TSO. PA presented no effect on myopia. Though the strength of evidence is less because of high heterogeneity and lack of clinical trials with clear definition, increased TSO and reduced NW are protective against myopia development among nonmyopes.

Keywords: Indoor activity; myopia; near work; physical activity; time spent outdoor.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Details about selection of articles. Note: SR – systematic review; MA – meta-analysis
Figure 2
Figure 2
Forest plot corresponding to main random-effects meta-analysis performed to quantify the relationship between the time spent on outdoor activities and the prevalence of myopia. Note: ES – effect size
See this image and copyright information in PMC

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