01/25/2024

January Kids Corner – 2023 American Academy of Optometry Recap 

The 2023 Binocular Vision, Perception, and Pediatric Optometry (BVPPO) and Cornea, Contact Lenses, and Refractive Technologies (CCLRT) Joint Symposium covered cutting-edge concepts and clinical recommendations in myopia management. During the symposium, Dr. Siofra Harrington of the Technological University Dublin discussed findings from the Ireland Eye Study (1,626 children ages 6 to 13 years) regarding how children’s visual environment influences their vision, eye health and general health. 

The study found that:  

• Emmetropes were 2x as likely to be a healthy weight while children with obesity were 3x more likely to be myopic. Higher BMI also was associated with worse stereo and visual acuity (near and far).  
• Physically inactive children were 4x more likely to be myopic.  
• Those breastfed for the first 3 months of life had decreased odds of myopia and obesity.   
• Odds for myopia increased 5x for children on screens > 4hrs/day and 3x for those on screens > 2hrs/day. 
• Spending < 1 hour outdoors per day increased the odds of myopia fivefold.  
• Socioeconomic disadvantage and ethnic minority status increased the odds of myopia, obesity, sedentary living, and less outdoor time.  
• The authors theorized that the Western hyperglycemic diet induces insulin resistance and elevated insulin-like growth factor, which may exacerbate scleral tissue growth, axial elongation, and myopia. Outdoors, relaxed accommodative demand, constricted pupils, and retinal dopamine release protect against increased axial length and myopia progression. Exposure to light at night and a desynchronized circadian rhythm is associated with myopia and obesity even when calorie intake and physical activity are constant.  
• The authors recommended 2 hours daily outdoor time. They also recommended that children hold screens no closer than 30cm for 30 minutes (30 – 30 rule) and then take a break. The authors concluded that increased physical activity and decreased near-sedentary activities are lifestyle changes that may reduce myopia.