Trial reportThe British journal of ophthalmology2026
Time outdoors prevents myopia in hyperopic children, but protection is weaker in premyopic children: a post-hoc analysis of a cluster-randomised trial.
Trial report in The British journal of ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact of exercise on myopia in children and adolescents and its modifying factors: a systematic review and meta-analysis.BMC pediatrics · 2026Pooled it
- Pre-Myopic Children: Trends in Myopia Development and Management in Canada.Journal of clinical medicine · 2026Article
- Defining the critical axial length threshold for transition from physiological growth to pathological fundus structural remodeling in adolescent myopia.Frontiers in cell and developmental biology · 2026Article
- Axial length changes and baseline predictors over five years in children treated with orthokeratology lenses: a retrospective cohort study.Frontiers in bioengineering and biotechnology · 2026Article
- Establishing and validating a predictive model for long-term control outcomes following orthokeratology lenses wear: a five-year cohort study.Frontiers in cell and developmental biology · 2026Article
- Management of myopia: a mini-review.Medical hypothesis, discovery & innovation ophthalmology journal · 2026Review
Corrections and comments
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo investigate the effect of time outdoors on myopic shift among premyopic children.
methodsPost-hoc analysis was nested in a cluster-randomised trial of the Shanghai Time Outside to Reduce Myopia (STORM) study. 6- to 9-year-old participants without myopia from the STORM study, who wore wristwatches to monitor time outdoors from 2017 to 2018, were included. Participants were all examined with cycloplegic refraction. Daily time outdoors was objectively monitored with the wearable smartwatch. Premyopia was defined as a cycloplegic spherical equivalent (SE) from -0.50 to +0.75 (inclusive) dioptres (D). Myopic shift was SE change from baseline to 1 year follow-up.
resultsAmong 3194 participants (1369 premyopic; mean age 8.2±0.6 years; 49.5% boys), there were no statistical differences between premyopic and hyperopic children in time outdoors (p=0.303). Hyperopes showed reduced myopic shift with increasing outdoor time (plateau at about 120 min/day). However, premyopes exhibited a J-shaped relationship between time outdoors and myopic shift. In comparison to the subgroup with daily time outdoors <60 min, the difference in SE change in the other subgroups was not statistically significant (61-90 min/d: -0.03 (95% CI -0.10 to 0.05); 91-120 min/d: -0.03 (95% CI -0.11 to 0.05)). The reduced myopic shift was only observed with time outdoors >120 min/d, although it was still not statistically significant (>120 min/d: 0.04 (95% CI -0.05 to 0.14)).
conclusionsAmong premyopic children, increased time outdoors has a limited protective effect on myopic shift, suggesting longer duration of time outdoors or additional interventions to prevent or delay myopia onset in this population.
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