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More Green Time
Less Screen Time

About the Author

Jagrut Lallu, Optometrist and founding member of the Australia and New Zealand Child Myopia Working Group.

We have all experienced significant change to our daily life this year, some changes we have embraced, and some has been challenging. Now we all have an opportunity to create a ‘new normal’ that works for each of us and our families. Giving children less time on devices and more outdoor time, plus more frequent breaks from screens, is an area that we now have the opportunity to improve as we start to live in a COVID-19 environment.

An increasingly digital world

Screen time has unavoidably become a big part of everyday learning and interaction, especially during the height of the coronavirus pandemic. It has had huge benefits in helping us to communicate and stay in touch.  However parents are often not aware of the association with low levels of outdoor activity1 and associated factors including low levels of light exposure2  and prolonged near tasks such as reading and screen time3 which may influence the development of myopia.

What is myopia?

Myopia is a common eye condition that causes blurred distance vision which usually starts during childhood and typically progresses until a child stops growing.  

Myopia is rapidly becoming a serious public health concern in New Zealand, yet research shows that 69% of New Zealand parents (with children up to 17 years old) do not know what myopia is, and only 12% of parents recognise the eye health conditions that their children might develop later in life from child myopia. The eyes grow from birth through to adulthood. If parents can start to instill good visual habits, like they do dental habits, it may help in the long term to reduce the growing rate of myopia globally.

The importance of outdoor play

Lifestyle factors including low levels of outdoor activity 4 may influence the development of myopia. 

More research is needed to determine if it is to do with the intensity or brightness of the light or the distances that children focus on, but what is proven is that there is a link between outdoor time and its benefit to a child’s myopia development.

Given that outdoor play is free, “more green time less screen time” is a timely reminder for moderation in an increasingly digital world.

What can parents do to help reduce the likelihood of their child developing myopia?

There are two main factors which can mean your child is more at risk of developing myopia: lifestyle and family history. 

The likelihood of developing myopia, particularly high myopia increases when one or both parents are myopic5. However, the exact link between a family history of myopia and development of childhood myopia remains uncertain6.

You can’t influence genetics, but parents can feel empowered when it comes to lifestyle factors.  

Top Three Myopia-Busting Tips:

  1. More green time less screen time!
  2. Build in regular breaks from devices – every twenty minutes remind your child to have a break for at least twenty seconds and look out a window to something at least 6 metres away7
  3. Talk to your local optometrist about all of the options to stop your child from having to change glasses prescriptions as frequently.

The world after lockdown needs to include some thought on all aspects of how we live our lives. One thing that it has taught us all is that there needs to be a balance. We have embraced technology in a huge global experiment for how we work, now is an opportunity to extend that to how we want our children to grow up. The Optometrist’s goal is to educate on a number of eye health topics. Myopia is one of these topics – if we think about how we are interacting with our environment i.e. more time outdoors less screen time we can influence the number of times glasses need to be changed in the future. 

By 2050, it is estimated that more than 50% of the world’s population will have myopia and 10% or almost 1 billion will have high myopia8. If we all encourage daily play time outdoors, we have an opportunity to halve that.  Each time a prescription for short-sightedness increases in strength there is an increased association with serious eye conditions later in life, including an increased risk in permanent sight loss9. However, action can be taken to manage myopia. Starting a conversation with your local optometrist is a positive first step. 

About the Australia and New Zealand Child Myopia Working Group

The Australia and New Zealand Child Myopia Working Group is a collaboration of leading optometrists and ophthalmologists. The Working Group’s aim is to set a recommended standard of care for child myopia management, in order to slow progression of myopia in children.  

To download a free copy of The Australia and New Zealand Child Myopia Report – A Focus on Future Management, launched in 2019 by the Australian and New Zealand Child Myopia Working Group click here. 

Members are :

  • Dr Rasha Altaie, Ophthalmologist, Auckland
  • Luke Arundel, Chief Clinical Officer, Optometry Australia, Melbourne 
  • Jagrut Lallu, Optometrist and Immediate Past President of the Cornea and Contact Lens Society of New Zealand (CCLSNZ), Hamilton
  • Margaret Lam, Optometrist and National President of the Cornea and Contact Lens Society of Australia (CCLSA), Sydney
  • Dr Loren Rose, Paediatric Ophthalmologist, Sydney
  • Andrew Sangster, Optometrist and Board Member of New Zealand Association of Optometrists, Wellington
  • Chair – Scientia Professor Fiona Stapleton, School of Optometry and Vision Science UNSW, Sydney

1 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; 314:1142-1148 
2 Read SA, Collins MJ, Vincent SJ. Light Exposure and Eye Growth in Childhood. Investigative Ophthalmology and Visual Science 2015: 56(11):6779-6787
3 Ip JM, Saw SM, Rose KA, Morgan IG, Kifley A, Wang JJ, Mitchell P. Role of Near Work in Myopia: Findings in a Sample of Australian School Children. Investigative Ophthalmology and Visual Science 2008:49(7):2903-2910
4 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; 314:1142-1148
5 Lim LT, Gong Y, Ah-Kee EY, Xiao G, Zhang X. Impact of parental history of myopia on the development of myopia in mainland China school-aged children. Ophthalmology and  Eye Disease. 2014;6:31-5
6 Ip J, Huynh S, Robaei D, Rose K, Morgan I, Smith W, Kifley A, Mitchell P. Ethnic differences in the impact of parental myopia: Findings from a population-based study of 12-year old Australian children. Investigative Ophthalmology and Visual Science. 2007:48:2520-2528
7 https://www.mykidsvision.org/en-us
8 ibid.
9 Fricke TR, Jong M, Naidoo KS, Sankaridurg P, Naduvilath TJ, Ho Suit SM, Wong TY, Resnikoff S, Global Prevalence of Visual Impairment Associated with Myopic Macular Degeneration and Temporal Trends from 2000 through 2050: Systematic Review, Meta-Analysys and Modelling. Br. J Opthalmol, April 2018