If you see school-aged kids in your practice, you already know the question is coming: “Is all this screen time ruining my child’s eyes?” It’s a valid concern—but the answer isn’t always as simple as “Less screen time, more outdoor time.”
Major studies, including the landmark Sydney Myopia Study and the more recent China-based trials, repeatedly show that children who spend at least 90 to 120 minutes outdoors daily have a significantly lower risk of becoming myopic.1,2 Although likely confounded by time spent on near work, outdoor light exposure is thought to stimulate retinal dopamine release, which helps regulate axial growth.
So, what should primary care optometrists really tell parents today? Here are 3 key, practical recommendations to keep the advice simple and evidence-based:
1. Prioritize Outdoor Time
Encourage at least 2 hours of outdoor activity per day when possible. This doesn’t mean organized sports only—free play counts! Even recess, walking the dog, or family walks after dinner fit the bill.
2. Break Up Near Work
Evidence indicates that “myopia-stop” signals are strongest when they follow sustained near work—meaning the timing and length of breaks matter.3
In clinical terms, the best break is at least 3 to 5 minutes long, ideally spent outdoors where the visual field is open and distance viewing is unrestricted and taken immediately after a prolonged period of close work. This should be no more than 15 minutes for handheld devices and 50 minutes for desktop distance.
3. Be Realistic About ScreenUse
Don’t guilt parents about screens—they’re not going away. Instead, inform them about these healthy habits for their children:
• Use larger screens when possible—external monitors instead of laptops or tablets.
• Keep screens out of bed (discourage late-night use).
• Avoid reading in the car.
• Use voice command instead of typing when possible.
A Clear Message
The best message is clear and realistic: Encourage more frequent outdoor time, guide families on practical screen habits, and combine lifestyle advice with evidence-based clinical options. OM
References
1. Rose KA, Morgan IG, Ip J, et al. Outdoor activity reduces the prevalence of myopia in children. Ophthalmology. 2008;115(8):1279-1285. doi:10.1016/j.ophtha.2007.12.019.
2. Mei Z, Zhang Y, Jiang W, et al. Efficacy of outdoor interventions for myopia in children and adolescents: a systematic review and meta-analysis of randomized controlled trials. Front Public Health. 2024;12:1452567. Published 2024 Aug 13. doi:10.3389/fpubh.2024.1452567.
3. Zhu X. Temporal integration of visual signals in lens compensation (a review). Exp Eye Res. 2013;114:69-76. doi:10.1016/j.exer.2013.02.014.
