Protective Behaviours of Near Work and Time Outdoors in Myopia Prevalence and Progression in Myopic Children: a 2-Year Prospective Population Study

  • This study aims to investigate the protective behaviours of longer near work distance, discontinuing near work and more time outdoors in recess from parent self-report in the myopia prevalence and progression among myopic children aged 9–11 years.

  • Myopia Investigation study in Taipei is a longitudinal population-based study that enrolled elementary school students in Taipei. 

  • Vision and refraction examination was conducted every 6 months. Spherical equivalent (SE) of cycloplegic refraction ≤−0.50 Diopter (D) is defined as myopia. Total 10 743 (70.4%) students completed 2-year refraction data and questionnaire. 

  • The myopia prevalence and progression (difference of SE) in baseline, 6, 12, 18 and 24 months were compared by generalised estimating equations.

  • Children with persistent protective behaviour had significant lower prevalence of myopia. 

  • The protective impact was statistically significant from 6 to 24 months. 

  • In 2 years follow-up, risk ratio after adjusting the background variables and the other two behaviours in near work distance, near work time and outdoor time were 0.71, 0.89 and 0.77. 

  • In SE analysis, after adjusting the other two behaviours, near work distance >30 cm (−0.7 vs −1.04 D; p<0.001), discontinuing near work every 30 min (−0.77 vs −0.96 D, p=0.005) and more time outdoors in recess from parent self-report (−0.75 vs −0.98 D; p=0.012) revealed protective impacts on diminishing myopia progression from 6 to 24 months.

  • In myopic children aged around 10 years in Taipei, longer distance in near work, discontinuing near work every 30 min and more outdoor time from parent self-report are protective behaviours in myopia prevalence and progression in 6–24 months.

Publication date

July 6, 2021


British Journal of Ophthalmology

Sponsor Institution

Department of Health, Taipei City Government


Huang P, Hsiao Y, Tsai C, et al
Share this