Relationship between Myopia and Light Exposure
Abstract
Epidemiological studies found that the incidence of myopia was increasing year by year and the age of onset of myopia was showing a trend of affecting increasingly younger children. Reducing the occurrence of myopia and controlling the increase of myopia diopter have always been the focus of research on the prevention and control of myopia. Large randomized controlled clinical trials have found that outdoor activities can effectively reduce the incidence of myopia and delay the progression of myopia. Basic experiments also revealed that there were certain connections between light exposure and myopia. We herein review the research progress, limitations and future directions of research on light exposure and myopia. From the perspective of light properties, increasing the intensity of light can slow the progression of myopia and reduce the occurrence of experimentally induced myopia. However, the actual mechanism of action is still unclear. The rhythmic changes of light exposure caused by the light/dark cycle may cause abnormalities in the secretion of melatonin and dopamine, and changes in the circadian rhythm of intraocular pressure and choroidal thickness, thus affecting myopia. The red light, with relatively longer wavelength and forming images behind the retina, tends to induce myopia more easily, while the blue light, with medium and short wavelength and forming images before the retina, tends to delay myopia progression. However, different species respond differently to lights of different wavelengths, and the relationship between light wavelength and myopia needs further investigation. Future research can be done to further explore the mechanism of action of how light exposure changes the progression of myopia, including the following aspects: how light changes dopamine levels, causing changes in downstream signal pathways, and thus controlling the growth of the axial length of the eye; how retinal photoreceptor cells receive light signals of different wavelengths in order to adjust the refractive power of the eyes; and how to design artificial lighting of reasonable intensity, composition and properties, and apply the design in myopia prevention and control.
Keywords: Myopia, Luminance, Monochromatic light, Light exposure rhythm, Flashing light, Dopamine
Full Text:
PDFReferences
MORGAN I G, OHNO-MATSUI K, SAW S M. Myopia. Lancet,2012, 379(9827): 1739–1748.
HOLDEN B, SANKARIDURG P, SMITH E, et al. Myopia, an underrated global challenge to vision: Where the current data takes us on myopia control. Eye (London),2014,28(2): 142–146.
HOLDEN B A, FRICKE T R, WILSON D A, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology,2016,123(5): 1036–1042.
WANG J, LI Y, ZHAO Z, et al. School-based epidemiology study of myopia in Tianjin, China. Int Ophthalmol,2020,40(9): 2213–2222.
VITALE S, SPERDUTO R D, FERRIS F L, 3rd. Increased prevalence of myopia in the United States between 1971-1972 and 1999-2004. Arch Ophthalmol,2009,127(12): 1632–1639.
XIONG S, SANKARIDURG P, NADUVILATH T, et al. Time spent in outdoor activities in relation to myopia prevention and control: A meta-analysis and systematic review. Acta ophthalmol,2017,95(6): 551–566.
CAO K, WAN Y, YUSUFU M, et al. Significance of outdoor time for myopia prevention: A systematic review and meta-analysis based on randomized controlled trials. Ophthalmic Res,2020,63(2): 97–105.
WU P C, CHEN C T, CHANG L C,et al . Increased time outdoors is followed by reversal of the long-term trend to reduced visual acuity in Taiwan primary school students. Ophthalmology, 2020,127(11):1462-1469
HE M, XIANG F, ZENG Y, et al. Effect of time spent outdoors at school on the development of myopia among children in China: A randomized clinical trial. JAMA,2015,314(11): 1142–1148.
GUO Y, LIU L, LV Y, et al. Outdoor jogging and myopia progression in school children from rural Beijing: The Beijing children eye study. Transl Vis Sci Technol,2019,8(3): 2[2021-07-02]. https://doi.org/10.1167/tvst.8.3.2.
NORTON T T, SIEGWART J T, Jr. Light levels, refractive development, and myopia—A speculative review. Exp Eye Res,2013,114: 48–57.
SHERWIN J C, REACHER M H, KEOGH R H, et al. The association between time spent outdoors and myopia in children and adolescents: A systematic review and meta-analysis. Ophthalmology,2012,119(10): 2141–2151.
READ S A, COLLINS M J, VINCENT S J. Light exposure and physical activity in myopic and emmetropic children. Optom Vis Sci,2014,91(3): 330–341.
FRENCH A N, ASHBY R S, MORGAN I G, et al. Time outdoors and the prevention of myopia. Exp Eye Res,2013,114: 58–68.
GUAN H, YU N N, WANG H, et al. Impact of various types of near work and time spent outdoors at different times of day on visual acuity and refractive error among Chinese school-going children. PLoS One, 2019,14(4): e0215827[2021-07-02]. https://doi.org/10.1371/journal. pone.0215827.
JIN J X, HUA W J, JIANG X, et al. Effect of outdoor activity on myopia onset and progression in school-aged children in northeast China: The Sujiatun eye care study. BMC Ophthalmol,2015,15: 73[2021-07-02]. https://doi.org/10.1186/s12886-015-0052-9.
HUA W J, JIN J X, WU X Y, et al. Elevated light levels in schools have a protective effect on myopia. Ophthalmic Physiol Opt,2015,35(3): 252–262.
WU P C, CHEN C T, LIN K K, et al. Myopia prevention and outdoor light intensity in a school-based cluster randomized trial. Ophthalmology,2018,125(8): 1239–1250.
MCKNIGHT C M, SHERWIN J C, YAZAR S, et al. Myopia in young adults is inversely related to an objective marker of ocular sun exposure: the Western Australian Raine cohort study. Am J Ophthalmol,2014, 158(5): 1079–1085.
LI M, LANCA C, TAN C S, et al. Association of time outdoors and patterns of light exposure with myopia in children. Br J Ophthalmol, 2021: bjophthalmol-2021-318918[2021-07-02]. https://doi.org/ 10.1136/bjophthalmol-2021-318918.
WEN L, CAO Y, CHENG Q, et al. Objectively measured near work, outdoor exposure and myopia in children. Br J Ophthalmol,2020, 104(11): 1542–1547.
LINGHAM G, MACKEY D A, ZHU K, et al. Time spent outdoors through childhood and adolescence—assessed by 25-hydroxyvitamin D concentration—and risk of myopia at 20 years. Acta ophthalmol,2021, 99(6): 679–687.
PAN C W, QIAN D J, SAW S M. Time outdoors, blood vitamin D status and myopia: A review. Photochem Photobiol Sci,2017,16(3): 426–432. ASHBY R,
OHLENDORF A, SCHAEFFEL F. The effect of ambient illuminance on the development of deprivation myopia in chicks. Invest Ophthalmol Vis Sci,2009,50(11): 5348–5354.
ASHBY R S, SCHAEFFEL F. The effect of bright light on lens compensation in chicks. Invest Ophthalmol Vis Sci,2010,51(10): 5247–5253.
SMITH E L, 3rd, HUNG L F, HUANG J. Protective effects of high ambient lighting on the development of form-deprivation myopia in Rhesus monkeys. Invest Ophthalmol Vis Sci,2012,53(1): 421–428.
SHE Z, HUNG L F, ARUMUGAM B, et al. The effects of reduced ambient lighting on lens compensation in infant Rhesus monkeys. Vision Res,2021,187: 14–26.
MCCARTHY C S, MEGAW P, DEVADAS M, et al. Dopaminergic agents affect the ability of brief periods of normal vision to prevent form-deprivation myopia. Exp Eye Res,2007,84(1): 100–107.
FELDKAEMPER M, SCHAEFFEL F. An updated view on the role of dopamine in myopia. Exp Eye Res,2013,114: 106–119.
MEGAW P, MORGAN I, BOELEN M. Vitreal dihydroxyphenylacetic acid (DOPAC) as an index of retinal dopamine release. Neurochem, 2001,76(6): 1636–1644.
Refbacks
- There are currently no refbacks.



