Myopia and Environmental Risk Factors: A Comprehensive Study

Abstract

Background: The global rise in the prevalence of myopia calls for evidence-based strategies to be devised to reduce the incidence and delay the progression of Myopia. The aim is to determine the relationship between myopia incidence and some environmental factors. Methods: A cross-section observational study was conducted at Alzahraa Teaching Hospital from May 2023 to December 2023. Primary school students of both genders. All students were enrolled in the study after an agreement with their parents/guards. Data was collected using a pre-constructed data collection sheet (questionnaire) including three sections, the first section was sent to the families to fill and sign the consent for participation and provide the required data including the demographic variables, family history and medical history of the students, time outdoors, prolonged near work/increased study hours, high BMI, use of LED lamps for homework, less sleeping hours, low Vitamin D levels, less participation in sports and low socioeconomic status. The second part included the general examination of the students, school grades and education performance (assessed according to the student school Cards). The third section involved the ophthalmological examination, visual acuity and ophthalmoscopic examination. Results: A total of 100 students were enrolled in this study, they were equally distributed according to gender, 50 boys and 50 girls. The age of students ranged between 6 and 12 years. Only 12 students had positive past medical and surgical history. A family history of myopia was reported in 20% of the studied group, 20 children were wearing spectacles and a history of past eye complaints was reported in 9 (9%) of children. The refractive errors were 45% hypermetropia, 39% myopia and 16% astigmatism. Abnormal visual acuity was detected in 35%. Myopia was significantly higher in children with family history (p=0.007). A statistically significant relationship was found between large time outdoors and myopia (OR=4.52, p=0.02). A statistically significant relationship was found between prolonged near-work/increased study hours and myopia (OR=4.52, p=0.02). A statistically significant relationship was found between using LED lamps for homework and myopia (OR=10.33, p<0.0001). A statistically significant relationship was found between fewer sleeping hours and myopia (OR=7.5, p<0.0001). Conclusion: Prevention of the onset of myopia and delay in the progression of myopia can be altered by modifying the contributing environmental risk factors. Raise outdoor time with adequate sunlight exposure, rural environment, less duration of near work, use of incandescent lamp and normal sleeping rhythms with adequate regular sleeping hours can prevent the onset and progression of myopia. Myopia is associated with high BMI, watching television and playing digital devices. High socioeconomic status associated with more indoor activity, increased academic pressure, sedentary lifestyle contribute to the prevalence of myopia.