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Outdoor activity and myopia in Singapore teenage children
  1. M Dirani1,2,
  2. L Tong1,
  3. G Gazzard3,
  4. X Zhang2,
  5. A Chia4,
  6. T L Young5,6,
  7. K A Rose7,
  8. P Mitchell8,
  9. S-M Saw2
  1. 1
    Singapore Eye Research Institute, Singapore
  2. 2
    Department of Community, Occupational and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  3. 3
    Glaucoma Research Unit, Moorfields Eye Hospital, London, UK
  4. 4
    Singapore National Eye Center, Singapore
  5. 5
    Duke National University of Singapore-Graduate Medical School, Singapore
  6. 6
    Duke University School of Medicine, Durham, North Carolina, USA
  7. 7
    Discipline of Orthoptics, University of Sydney, Sydney, Australia
  8. 8
    Department of Ophthalmology, University of Sydney, Sydney, Australia
  1. Correspondence to Dr M Dirani, Department of Community, Occupational and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, MD3, 16 Medical Drive, Singapore 117597; dirani{at}


Aim: To investigate the relationship of outdoor activities and myopia in Singapore teenage children.

Methods: Teenage children (1249 participants), examined in the Singapore Cohort study Of Risk factors for Myopia (SCORM), during 2006 were included in analyses. Participants completed questionnaires that quantified total outdoor activity, and underwent an eye examination.

Results: The mean total time spent on outdoor activity was 3.24 h/day. The total outdoor activity (h/day) was significantly associated with myopia, odds ratio 0.90 (95% CI 0.84 to 0.96) (p = 0.004), after adjusting for age, gender, ethnicity, school type, books read per week, height, parental myopia, parental education and intelligence quotient. In addition, the total time spent outdoors was associated with significantly less myopic refraction (regression coefficient = 0.17; CI 0.10 to 0.25, p<0.001) and shorter axial length (regression coefficient −0.06 (CI −0.1 to −0.03, p<0.001). Total sports was also significantly negatively associated with myopia (p = 0.008) but not indoor sports (p = 0.16).

Conclusions: Participants who spent more time outdoors were less likely to be myopic. Thus, outdoor activity may protect against development of myopia in children, supporting recent Australian data. As near work did not predict outdoor activity, this can be viewed as an independent factor and not merely the reciprocal of near work.

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  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Singapore Eye Research Institute (SERI) Institutional Review Board (IRB).

  • Patient consent Obtained from the parents.