Spending time outdoors is good for your children's eyesight. Here's why

If you, as a parent, find it difficult to get your kids off their devices and outside to play, there's another reason to keep trying: Spending at least two hours outside every day is one of the most important things things your children can do to protect their eyesight.

“We believe that spending time outdoors is the best form of myopia prevention,” says Dr. Noha Ekdawi, a pediatric ophthalmologist in Wheaton, Illinois.

And that's important because the number of children with myopia – or nearsightedness – is increasing rapidly in the United States and many other parts of the world.

In the United States, 42% of people are nearsighted today, up from 25% in the 1970s. In some East Asian countries, up to 90% of people are nearsighted by young adulthood.

It's a trend Ekdawi has observed in her own young patients. When she started practicing 15 years ago, one or two of the children she visited had nearsightedness. But these days, “about 50% of my patients suffer from myopia, which is an incredibly high number.” Ekdawi calls the increase astronomical.

Myopia occurs when the eyeball expands and becomes too long, causing distant objects to appear blurry.

Once a child suffers from nearsightedness, their eyeball continues to expand and the condition progressively worsens. If they develop severe nearsightedness, it can increase the risk of serious eye problems such as retinal detachments, glaucoma and cataracts. It can even lead to blindness.

There are treatments that can slow the progression of myopia, including prescription atropine eye drops, special soft disposable contact lenses called MiSight, and hard contact lenses worn overnight known as orthokeratology or Ortho-K. However, Ekdawi says the best approach is to protect children from developing myopia in the first place.

So how can spending time outside help?

That's what Ian Morgan wanted to find out. Morgan is a myopia researcher at the Australian National University. A few decades ago he found that rates of myopia were much higher in East Asia than in Sydney.

He knew from animal experiments that light stimulates the eye to release the neurotransmitter dopamine, which can slow the expansion of the eyeball. “Australians are famous for their outdoorsy lifestyle,” he thought. “Perhaps there is a connection between being outside a lot and preventing the development of myopia.”

To test this theory, he and his colleagues designed a two-year study of more than 4,000 6- and 12-year-olds in Sydney. It turns out the researchers were right.

“The children who reported spending more time outdoors were less likely to be nearsighted and, as we later showed, also less likely to be nearsighted,” Morgan says of the findings published in 2008.

Morgan's research caught the attention of Dr. Pei-Chang Wu, an ophthalmologist in Taiwan. As a retina specialist at Chang Gung Memorial Hospital in Kaohsiung, he had seen the effects of high myopia in patients as young as ten years old with tears in their retinas. Some even experienced retinal detachment – which can lead to blindness if not treated quickly.

At the time, Wu's young son was just starting first grade, and he was worried about the astronomically high rates of myopia in Taiwan. About 90 percent of teenagers there make it to the end of high school. According to Wu, the academic culture in Taiwan's elementary schools did not allow for many outdoor recesses. “Many teachers want students to practice their homework during recess,” he says.

But Wu convinced his son's elementary school to spend more time outdoors. He also recruited a control school. A year later, his son's school had half as many new myopia cases as the other school. “We saw the results – they were very successful,” says Wu.

He researched more schools and eventually convinced the Taiwanese Ministry of Education to encourage all elementary schools to send their students outdoors for at least two hours every day. The program started in September 2010. And after decades of upward trends, the myopia rate among Taiwan's primary school students began to decline – from an all-time high of 50% in 2011 to 45.1% in 2015. This is a major achievement, says Ian Morgan.

“The people who have led the pack are certainly the people of Taiwan,” Morgan says.

According to research, to maintain this vision protection, children should spend at least two hours outdoors every day. And the sooner you intervene, the better.

“For me it means: eat your vegetables. You have to spend time outside,” says Ekdawi.

It doesn't matter whether it's sunny or cloudy – or what the children are doing. “You can go to the park, you can ride a bike, you can sit and be a tree, you can walk your dog. All of those things matter,” she says.

And if you're worried about leaving time for homework, Ekdawi suggests having your kids do it outside, too. As long as they are outdoors, it depends.

This story was edited by Jane Greenhalgh

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