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The Xichang Pediatric Refractive Error Study Report No. 2

Bei Lu, MD; Nathan Congdon, MD, MPH; Xiaojian Liu, MPH; Kai Choi, PhD; Dennis S. C. Lam, MBBS, MD, FRCOphth; Mingzhi Zhang, MD; Mingwei Zheng, BS; Zhongxia Zhou, MD; Liping Li, PhD; Xueyu Liu, MPH; Abhishek Sharma, MBBS; Yue Song, MD, PhD

Arch Ophthalmol. 2009;127(6):769-775.

Objective  To study the associations between near work, outdoor activity, and myopia among children attending secondary school in rural China.

Methods  Among a random cluster sample of 1892 children in Xichang, China, subjects with an uncorrected acuity of 6/12 or less in either eye (n = 984) and a 25% sample of children with normal vision (n = 248) underwent measurement of refractive error. Subjects were administered a questionnaire on parental education, time spent outdoors, and weekly time spent engaged in and preferred working distance for a variety of near-work activities.

Results  Among 1232 children with refraction data, 998 (81.0%) completed the near-work survey. Their mean age was 14.6 years (SD, 0.8 years), 55.6% were girls, and 83.1% had myopia of –0.5 diopters or less (more myopia) in both eyes. Time and diopter-hours spent on near activities did not differ between children with and without myopia. In regression models, time spent on near activities and time outdoors were unassociated with myopia, adjusting for age, sex, and parental education.

Conclusions  These and other recent results raise some doubts about the association between near work and myopia. Additional efforts to identify other environmental factors associated with myopia risk and that may be amenable to intervention are warranted.

Author Affiliations: Joint Shantou International Eye Center of Shantou University and Chinese University of Hong Kong, Shantou, China (Drs Lu, Congdon, Lam, Zhang, Zhou, and Song, and Ms Zheng); Department of Ophthalmology and Visual Science, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China (Drs Congdon, Lam, and Sharma); Shantou University Medical College, Shantou (Mr Xiaojian Liu, Dr Li, and Ms Xueyu Liu); Centre for Epidemiology and Biostatistics, Chinese University of Hong Kong School of Public Health, Hong Kong, China (Dr Choi); and Oxford University, Oxford, England (Dr Sharma).

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