Physical Activity Spaces Not Effective against Socioeconomic Inequalities in Myopia Incidence

  • The aims of this study were to evaluate socioeconomic inequalities in myopia incidence, eye growth, outdoor exposure, and computer use, and to investigate if newly introduced physical activity spaces can reduce eye growth in school-aged children.

  • Participants (n = 2643) from the Dutch population-based birth cohort Generation R were examined at ages 6 and 9 years. Socioeconomic inequalities in myopia incidence, eye growth and lifestyle were determined using regression analyses. Information on physical activity spaces located in Rotterdam was obtained. Differences in eye growth between those who became exposed to new physical activity spaces (n = 230) and those non-exposed (n = 1866) were evaluated with individual level fixed-effects models.

  • Myopia prevalence was 2.2% at 6 years and 12.2% at 9 years. Outdoor exposure was 11.4 hours/week at 6 years and 7.4 hours/week at 9 years. Computer use was 2.1 hours/week at 6 years, and 5.2 hours/week at 9 years. Myopia incidence was higher in children with non-Dutch background, families with lower household income and lower maternal education.

  • Children living <600 meters of a physical activity space did not have increased outdoor exposure, except those from families with lower maternal education (β = 1.33 hours/week, 95%CI = 0.15-2.51). Newly introduced physical activity spaces were not associated with reduction of eye growth.

  • Children from socioeconomically disadvantaged families became more often myopic than those from socioeconomically advantaged families. We did not find evidence that physical activity spaces protect against myopia for the population at large, but subgroups may benefit.

Publication date

November 29, 2021


Optometry and Vision Science


Enthoven, Clair A. MSc; Mölenberg, Famke J. M. MSc; Tideman, J. Willem L. MD, PhD; Polling, Jan Roelof BSc; Labrecque, Jeremy A. PhD; Raat, Hein MD, PhD; van Lenthe, Frank J. PhD; Klaver, Caroline C. W. MD, PhD
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