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Title: Time outdoors at specific ages during early childhood and the risk of incident myopia
Authors: Shah, RL
Huang, Y 
Guggenheim, JA
Williams, C
Keywords: Myopia
Refractive error
Time outdoors
Issue Date: 2017
Publisher: Association for Research in Vision and Ophthalmology
Source: Investigative ophthalmology and visual science, 2017, v. 58, no. 2 How to cite?
Journal: Investigative ophthalmology and visual science 
Abstract: PURPOSE. Time outdoors during childhood is negatively associated with incident myopia. Consequently, additional time outdoors has been suggested as a public health intervention to reduce the prevalence of myopia. We investigated whether there were specific ages during early childhood when the time outdoors versus incident myopia association was strongest.
METHODS. Children participating in the Avon Longitudinal Study of Parents and Children (ALSPAC) were studied from age 2 to 15 years. Parentally reported time outdoors and time spent reading were assessed longitudinally in early childhood (ages 2, 3, 4, 5, 7, and 9 years). Noncycloplegic autorefraction was carried out longitudinally in later childhood (ages 10, 11, 12, and 15 years). Information was available for 2833 participants. Cox proportional hazards regression was used to test for association between time outdoors and incident myopia.
RESULTS. From 3 years of age onward, greater time outdoors was associated with a reduced risk of incident myopia. The hazard ratio for myopia changed progressively from 0.90 (95% CI 0.83-0.98, P = 0.012) at age 3 years, to 0.86 (95% CI 0.78-0.93, P = 0.001) at age 9 years, for each additional SD of time spent outdoors per day. These associations were independent of two major risk factors for myopia: time reading and number of myopic parents.
CONCLUSIONS. Additional time spent outdoors across the 3 to 9 years age range was associated with a reduced incidence of myopia between ages 10 and 15 years. There was a trend for the association to increase toward the older end of the 3 to 9 years range.
ISSN: 0146-0404
EISSN: 1552-5783
DOI: 10.1167/iovs.16-20894
Rights: This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The following article: Rupal L. Shah, Yu Huang, Jeremy A. Guggenheim, Cathy Williams; Time Outdoors at Specific Ages During Early Childhood and the Risk of Incident Myopia. Invest. Ophthalmol. Vis. Sci. 2017;58(2):1158-1166 is available at https//
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