Decades of Research. One Practical Implementation Tool.

Effect of time spent outdoors at school on the development of myopia among children in China: a randomized clinical trial

He M, Xiang F, Zeng Y, Mai J, Chen Q, Zhang J, Smith W, Rose K, Morgan IG

JAMA 2015;314(11):1142-1148

doi: 10.1001/jama.2015.10803

Outdoor activity during class recess reduces myopia onset and progression in school children

Wu PC, Tsai CL, Wu HL, Yang YH, Kuo HK

Ophthalmology 2013;120(5):1080-1085

doi: 10.1016/j.ophtha.2012.11.009

Myopia prevention and outdoor light intensity in a school-based cluster randomized trial

Wu PC, Chen CT, Lin KK, Sun CC, Kuo CN, Huang HM, Poon YC, Yang ML, Chen CY, Huang JC, Wu PC, Yang IH, Yu HJ, Fang PC, Tsai CL, Chiou ST, Yang YH

Ophthalmology 2018;125(8):1239-1250

doi: 10.1016/j.ophtha.2017.12.011

Time outdoors in reducing myopia: a school-based cluster randomized trial with objective monitoring of outdoor time and light intensity

He X, Sankaridurg P, Wang J, Chen J, Naduvilath T, He M, Zhu J, Li W, Morgan IG, Xiong S, Rose K, Weng R, Resnikoff S, Xu X

Ophthalmology 2022;129(11):1245-1254

doi: 10.1016/j.ophtha.2022.06.024

Smartwatch measures of outdoor exposure and myopia in children

Chen J, Cao K, Hu Y, Wan Y, He X, Xu X

JAMA Network Open 2024;7(8):e2424595

doi: 10.1001/jamanetworkopen.2024.24595

Development of the FitSight fitness tracker to increase time outdoors to prevent myopia

Verkicharla PK, Ramamurthy D, Nguyen QD, Zhang X, Pu SH, Malhotra R, Ostbye T, Lamoureux EL, Saw SM

Translational Vision Science & Technology 2017;6(3):20

doi: 10.1167/tvst.6.3.20

Association of time outdoors and patterns of light exposure with myopia in children

Li M, Lanca C, Tan CS, Foo LL, Sun CH, Yap F, Najjar RP, Sabanayagam C, Saw SM

British Journal of Ophthalmology 2023;107(1):133-139

doi: 10.1136/bjophthalmol-2021-318918

Light exposure and eye growth in childhood

Read SA, Collins MJ, Vincent SJ

Investigative Ophthalmology & Visual Science 2015;56(11):6779-6787

doi: 10.1167/iovs.14-15978

Time spent in outdoor activities in relation to myopia prevention and control: a meta-analysis and systematic review

Xiong S, Sankaridurg P, Naduvilath T, Zang J, Zou H, Zhu J, Lv M, He X, Xu X

Acta Ophthalmologica 2017;95(6):551-566

doi: 10.1111/aos.13403

Is spending more time outdoors able to prevent and control myopia in children and adolescents? A meta-analysis

Yang Y, Li R, Ge L, Zeng L

Ophthalmic Research 2024;67(1):393-404

doi: 10.1159/000539229

Significance of outdoor time for myopia prevention: a systematic review and meta-analysis based on randomized controlled trials

Cao K, Wan Y, Yusufu M, Wang N

Ophthalmic Research 2020;63(2):97-105

doi: 10.1159/000501937

Time spent outdoors as an intervention for myopia prevention and control in children: an overview of systematic reviews

Dhakal R, Lawrenson JG, Huntjens B, Shah R, Verkicharla PK

Ophthalmic and Physiological Optics 2022;42(3):545-558

doi: 10.1111/opo.12945

Efficacy of outdoor interventions for myopia in children and adolescents: a systematic review and meta-analysis of randomized controlled trials

Chen Y, Li X, Zhang Y, et al.

Frontiers in Public Health 2024;12:1452567

doi: 10.3389/fpubh.2024.1452567

The association between time spent outdoors and myopia in children and adolescents: a systematic review and meta-analysis

Sherwin JC, Reacher MH, Keogh RH, Khawaja AP, Mackey DA, Foster PJ

Ophthalmology 2012;119(10):2141-2151

doi: 10.1016/j.ophtha.2012.04.020

Effect of outdoor activities in myopia control: meta-analysis of clinical studies

Deng L, Pang Y

Optometry and Vision Science 2019;96(4):276-282

doi: 10.1097/OPX.0000000000001357

Time spent outdoors in childhood is associated with reduced risk of myopia as an adult

Lingham G, Yazar S, Lucas RM, Milne E, Hewitt AW, Hammond CJ, MacGregor S, Rose KA, Chen FK, He M, Guggenheim JA, Mackey DA

Scientific Reports 2021;11:6337

doi: 10.1038/s41598-021-85825-y

Time spent outdoors in childhood related to myopia among young adults in the Swedish ABIS cohort

Bro T, Ludvigsson J

Acta Ophthalmologica 2024;103(2):171-176

doi: 10.1111/aos.16688

IMI – Interventions for controlling myopia onset and progression report

Wildsoet CF, Chia A, Cho P, Guggenheim JA, Polling JR, Read S, Sankaridurg P, Saw SM, Trier K, Walline JJ, Wu PC, Wolffsohn JS

Investigative Ophthalmology & Visual Science 2019;60(3):M106-M131

doi: 10.1167/iovs.18-25958

IMI 2024 Digest: The role of light in refractive development and myopia

Ashby R, Harb EN, Reilly MA, Read SA, Smith EL

Investigative Ophthalmology & Visual Science 2025;66(15):5

doi: 10.1167/iovs.66.15.5

Outdoor activity reduces the prevalence of myopia in children

Rose KA, Morgan IG, Ip J, Kifley A, Huynh S, Smith W, Mitchell P

Ophthalmology 2008;115(8):1279-1285

doi: 10.1016/j.ophtha.2007.12.019

Time outdoors and physical activity as predictors of incident myopia in childhood: a prospective cohort study

Guggenheim JA, Northstone K, McMahon G, Ness AR, Deere K, Mattocks C, Pourcain BS, Williams C

Investigative Ophthalmology & Visual Science 2012;53(6):2856-2865

doi: 10.1167/iovs.11-9091

Risk factors for incident myopia in Australian schoolchildren: the Sydney Adolescent Vascular and Eye Study

French AN, Morgan IG, Mitchell P, Rose KA

Ophthalmology 2013;120(10):2100-2108

doi: 10.1016/j.ophtha.2013.02.035

Parental history of myopia, sports and outdoor activities, and future myopia

Jones LA, Sinnott LT, Mutti DO, Mitchell GL, Moeschberger ML, Zadnik K

Investigative Ophthalmology & Visual Science 2007;48(8):3524-3532

doi: 10.1167/iovs.06-1118

Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050

Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, Wong TY, Naduvilath TJ, Resnikoff S

Ophthalmology 2016;123(5):1036-1042

doi: 10.1016/j.ophtha.2016.01.006

The epidemics of myopia: aetiology and prevention

Morgan IG, French AN, Ashby RS, Guo X, Ding X, He M, Rose KA

Progress in Retinal and Eye Research 2018;62:134-149

doi: 10.1016/j.preteyeres.2017.09.004

The effect of bright light on lens compensation in chicks

Ashby RS, Schaeffel F

Investigative Ophthalmology & Visual Science 2010;51(10):5247-5253

doi: 10.1167/iovs.09-4689

The complex interactions of retinal, optical and environmental factors in myopia aetiology

Flitcroft DI

Progress in Retinal and Eye Research 2012;31(6):622-660

doi: 10.1016/j.preteyeres.2012.06.004

How does spending time outdoors protect against myopia? A review

Lingham G, Mackey DA, Lucas R, Yazar S

British Journal of Ophthalmology 2020;104(5):593-599

doi: 10.1136/bjophthalmol-2019-314675

Patterns of daily outdoor light exposure in Australian and Singaporean children

Read SA, Vincent SJ, Tan CS, Ngo C, Collins MJ, Saw SM

Translational Vision Science & Technology 2018;7(3):8

doi: 10.1167/tvst.7.3.8

The effects of different outdoor environments, sunglasses and hats on light levels: implications for myopia prevention

Lanca C, Teo A, Vivagandan A, Htoon HM, Najjar RP, Spiegel DP, Pu SH, Saw SM

Translational Vision Science & Technology 2019;8(4):7

doi: 10.1167/tvst.8.4.7

Prediction of juvenile-onset myopia

Zadnik K, Sinnott LT, Cotter SA, Jones-Jordan LA, Kleinstein RN, Manny RE, Twelker JD, Mutti DO; CLEERE Study Group

JAMA Ophthalmology 2015;133(6):683-689

doi: 10.1001/jamaophthalmol.2015.0471

The association between time spent outdoors and myopia using a novel biomarker of outdoor light exposure

Sherwin JC, Hewitt AW, Coroneo MT, Kearns LS, Griffiths LR, Mackey DA

Investigative Ophthalmology & Visual Science 2012;53(8):4363-4370

doi: 10.1167/iovs.11-8677

Objectively measured light exposure in emmetropic and myopic adults

Ostrin LA

Optometry and Vision Science 2017;94(2):229-238

doi: 10.1097/OPX.0000000000001013

Light levels, refractive development, and myopia — a speculative review

Norton TT, Siegwart JT

Experimental Eye Research 2013;114:48-57

doi: 10.1016/j.exer.2013.05.004

An updated view on the role of dopamine in myopia

Feldkaemper M, Schaeffel F

Experimental Eye Research 2013;114:106-119

doi: 10.1016/j.exer.2013.02.007

Increased time outdoors is followed by reversal of the long-term trend to reduced visual acuity in Taiwan primary school students

Wu PC, Chen CT, Chang LC, Niu YZ, Chen ML, Liao LL, Rose K, Morgan IG

Ophthalmology 2020;127(11):1462-1469

doi: 10.1016/j.ophtha.2020.01.054

Myopia, lifestyle, and schooling in students of Chinese ethnicity in Singapore and Sydney

Rose KA, Morgan IG, Smith W, Burlutsky G, Mitchell P, Saw SM

Archives of Ophthalmology 2008;126(4):527-530

doi: 10.1001/archopht.126.4.527

Time spent in outdoor light is associated with mood, sleep, and circadian rhythm-related outcomes: a cross-sectional and longitudinal study in over 400,000 UK Biobank participants

Burns AC, Saxena R, Vetter C, Phillips AJK, Lane JM, Cain SW

Journal of Affective Disorders 2021;295:347-352

doi: 10.1016/j.jad.2021.08.056

Associations of outdoor play and screen time with nocturnal sleep duration and pattern among young children

Xu H, Wen LM, Hardy LL, Rissel C

Acta Paediatrica 2016;105(3):297-303

doi: 10.1111/apa.13285

Associations of light exposure patterns with sleep among Dutch children: the ABCD cohort study

Stefanopoulou M, Ruhé N, Portengen L, van Wel L, Vrijkotte TGM, Vermeulen R, Huss A

Journal of Sleep Research 2024;33(6):e14184

doi: 10.1111/jsr.14184

Nature and children's health: a systematic review

Fyfe-Johnson AL, Hazlehurst MF, Perrins SP, Bratman GN, Thomas R, Garrett KA, Hafferty KR, Cullaz TM, Marcuse EK, Tandon PS

Pediatrics 2021;148(4):e2020049155

doi: 10.1542/peds.2020-049155

Outdoor time, physical activity, sedentary time, and health indicators at ages 7 to 14: 2012/2013 Canadian Health Measures Survey

Larouche R, Garriguet D, Gunnell KE, Goldfield GS, Tremblay MS

Health Reports 2016;27(9):3-13

doi: 27655167

Mental health benefits of interactions with nature in children and teenagers: a systematic review

Tillmann S, Tobin D, Avison W, Gilliland J

Journal of Epidemiology and Community Health 2018;72(10):958-966

doi: 10.1136/jech-2018-210436

What is the relationship between outdoor time and physical activity, sedentary behaviour, and physical fitness in children? A systematic review

Gray C, Gibbons R, Larouche R, Sandseter EBH, Bienenstock A, Brussoni M, Chabot G, Herrington S, Janssen I, Pickett W, Power M, Stanger N, Sampson M, Tremblay MS

International Journal of Environmental Research and Public Health 2015;12(6):6455-6474

doi: 10.3390/ijerph120606455

Outdoor time is associated with physical activity, sedentary time, and cardiorespiratory fitness in youth

Schaefer L, Plotnikoff RC, Majumdar SR, Mollard R, Woo M, Sadman R, Rinaldi RL, Boulé N, Torrance B, Ball GDC, Veugelers P, Wozny P, McCargar L, Downs S, Lewanczuk R, Gleddie D, McGavock J

The Journal of Pediatrics 2014;165(3):516-521

doi: 10.1016/j.jpeds.2014.05.029

A prospective examination of children's time spent outdoors, objectively measured physical activity and overweight

Cleland V, Crawford D, Baur LA, Hume C, Timperio A, Salmon J

International Journal of Obesity 2008;32(11):1685-1693

doi: 10.1038/ijo.2008.171