title: Outdoor activity and myopia in Singapore teenage children.
abstract: OBJECTIVE
  To investigate the relationship of outdoor activities and myopia in Singapore teenage children.
  
  
  METHODS
  Teenage children (1249 participants), examined in the Singapore Cohort study Of Risk factors for Myopia (SCORM), during 2006 were included in analyses. Participants completed questionnaires that quantified total outdoor activity, and underwent an eye examination.
  
  
  RESULTS
  The mean total time spent on outdoor activity was 3.24 h/day. The total outdoor activity (h/day) was significantly associated with myopia, odds ratio 0.90 (95% CI 0.84 to 0.96) (p = 0.004), after adjusting for age, gender, ethnicity, school type, books read per week, height, parental myopia, parental education and intelligence quotient. In addition, the total time spent outdoors was associated with significantly less myopic refraction (regression coefficient = 0.17; CI 0.10 to 0.25, p<0.001) and shorter axial length (regression coefficient -0.06 (CI -0.1 to -0.03, p<0.001). Total sports was also significantly negatively associated with myopia (p = 0.008) but not indoor sports (p = 0.16).
  
  
  CONCLUSIONS
  Participants who spent more time outdoors were less likely to be myopic. Thus, outdoor activity may protect against development of myopia in children, supporting recent Australian data. As near work did not predict outdoor activity, this can be viewed as an independent factor and not merely the reciprocal of near work.
authors.affiliation: Singapore Eye Research Institute, and Department of Community, Occupational and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, MD3, 16 Medical Drive, Singapore 117597. dirani@unimelb.edu.au
authors.forename: M
authors.initials: M
authors.lastname: Dirani
authors.forename: L
authors.initials: L
authors.lastname: Tong
authors.forename: G
authors.initials: G
authors.lastname: Gazzard
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.forename: A
authors.initials: A
authors.lastname: Chia
authors.forename: T L
authors.initials: TL
authors.lastname: Young
authors.forename: K A
authors.initials: KA
authors.lastname: Rose
authors.forename: P
authors.initials: P
authors.lastname: Mitchell
authors.forename: S-M
authors.initials: SM
authors.lastname: Saw
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008297:Male; D009216:Myopia / Q000453:epidemiology / Q000517:prevention & control*; D012737:Sex Factors; D012846:Singapore / Q000453:epidemiology; D013177:Sports / Q000706:statistics & numerical data*; D013997:Time Factors; D055815:Young Adult