THE IMPACT OF LIFESTYLE AND ENVIRONMENTAL FACTORS ON MYOPIA PROGRESSION IN CHILDREN
Main Article Content
Keywords
Myopia progression, outdoor activity, near-work, screen time, parental myopia
Abstract
Myopia is now one of the most important pediatric eye health issues globally because of its rising prevalence coupled with long-term complications that include retinal detachment and glaucoma. This study is aimed to understand the role of the lifestyle/environmental factors on the progression of myopia in Pakistani children. A prospective cohort at Tertiary Care Hospital, Karachi from January 2023 to December 2024. A sample of 3,600 school children (aged 6–12 years) was enrolled by multistage sampling from schools and outpatient clinics. Assessment at baseline and 12- and 24-m follow-ups comprised cycloplegic refraction, axial length measurement, best-corrected visual acuity and ocular health. Eight questionnaires, activity diaries and an embedded objective sample (wearable light sensor and accelerometer) established detailed information of all outdoor activities performed during the study periods, near-work related factors, screen time, sleep duration and physical activity. This yielded striking age-related differences in myopia development. The mean spherical equivalent refraction shift was −0.89 ± 0.54 D at 24 months with younger children (6–8 years) progressing faster than older children. Outdoor time was identified as the most significant protective factor, with each additional hour spent outside daily related to slowing of myopia progression by -0.21 D (p<0.001). In comparison, both near-work as well as screen use significantly increased myopic shift independently (−0.18 D and −0.14 D per additional daily hour; both p<0.001). Parental myopia was the main non-modifiable risk factor; children of myopic parents had an extra −0.25 D progression over two years (p<0.001). Sleep length was modestly associated, and the children sleeping < 8 hours showed a faster of the disease course. Questionnaires responses in activity were verified against objective activity with high correlations for outdoor time, near work and physical activity r=0.82, r=0.79 and 0.76 respectively; the same behavioral associations were found with refractive change. These results offer strong, quantifiable evidence that modifiable lifestyle factors interact with genetic propensity to influence the trajectory of myopia during mid-childhood.
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Aruna Devi
Dow University of Health Sciences, Karachi
Versha Devi
People's University of Medical and Health Sciences, Nawabshah
Sabahat Khalid
United Medical and Dental College, Karachi
Muhammad Muthar Anees
Liaquat College of Medicine and Dentistry, Karachi
Uzma Abdul Jabbar
Bahria University of Health Sciences, Karachi
Seema Aftab
Dow University of Health Sciences, Karachi
Hafiza Sidra Khan
Ayub Teaching Hospital, Abbottabad
Areesha
Karachi Medical and Dental College, Karachi
Ali Khan
Jinnah Postgraduate Medical Centre, Karachi