A century ago, it was widely believed that high levels of daylight in classrooms could prevent myopia, and as such, education departments built schools with large windows to try to stop children becoming short-sighted. This practice continued until the 1960s, from which time myopia was believed to be an inherited condition. In the years that followed, less emphasis was placed on preventing myopia. It has since become more common, reaching epidemic levels in east Asia. Recent research strongly suggests that the amount of light children get as they grow determines whether they will develop short sight; however, evidence that daylight in classrooms prevents myopia is lacking. Given the rapid increase in prevalence among school children worldwide, this should be investigated.
MorganIGOhno-MatsuiKSawSM. Myopia. The Lancet2012; 379(9827):1739–48.
2.
VitaleSSperdutoRDFerrisFL3rd. Increased prevalence of myopia in the United States between 1971–1972 and 1999–2004. Archives of Ophthalmology2009; 127: 1632–9.
3.
VitaleSCotchMFSperdutoREllweinL. Costs of refractive correction of distance vision impairment in the United States, 1999–2002. Ophthalmology2006; 113: 2163–70.
4.
SmithTSTFrickKDHoldenBAFrickeTRNaidooKS. Potential lost productivity resulting from the global burden of uncorrected refractive error. Bulletin of the World Health Organization2009; 87(6): 431–7.
5.
FredrickDR. Myopia. British Medical Journal2002; 324(7347): 1195–9.
DavidsonSQuinnGE. The impact of pediatric vision disorders in adulthood. Pediatrics2011; 127: 334–9.
8.
PinquartMPfeifferJP. Body image in adolescents with and without visual impairment. British Journal of Visual Impairment2012; 30: 122–31.
9.
MarkHH. Johannes Kepler on the eye and vision. American Journal of Ophthalmology1971; 72: 869–78.
10.
BarringtonAPearsonK. A First Study of the Inheritance of Vision and the Relative Influence of Heredity and Environment on Sight (Eugenics Laboratory Memoirs V). London: Dulau and Co., 1909.
11.
HarmanNB. The effects of school life upon the vision of the child. Proceedings of the Royal Society of Medicine1909; 2(Sect Study Dis Child): 206–16.
12.
SorsbyA. Refraction and its components in twins. Privy Council. Medical Research Council Special report no. 303. London: HMSO, 1962.
13.
ThompsonE. Some statistics of myopia with remarks thereon. British Journal of Ophthalmology1919; 3(7): 303–10.
14.
HessAF. Rickets, Osteomalacia and Tetany. London: Henry Kimpton, 1930.
15.
GwiazdaJDengLMannyRNortonTM; COMET Study Group. Seasonal variations in the progression of myopia in children enrolled in the correction of myopia evaluation trial. Investigative Ophthalmology & Visual Science2014; 55: 752–8.
16.
Beck-NielsenSSBrock-JacobsenBGramJBrixenKJensenTK. Incidence and prevalence of nutritional and hereditary rickets in southern Denmark. European Journal of Endocrinology2009; 160(3): 491–7.
17.
LamDSFanDSLamRFRaoSKChongKSLauJT. The effect of parental history of myopia on children’s eye size and growth: Results of a longitudinal study. Investigative Ophthalmology & Visual Science2008; 49: 873–6.
18.
MorganIRoseK. How genetic is school myopia?Progress in Retinal and Eye Research2005; 24: 1–38.
19.
WojciechowskiR. Nature and nurture: The complex genetics of myopia and refractive error. Clinical Genetics2011; 79(4): 301–20.
20.
FuchsE. Textbook of Ophthalmology. New York: D. Appleton & Company, 1899.
21.
RoseKAMorganIGIpJMKifleyAHuynhSSmithW. Outdoor activity reduces the prevalence of myopia in children. Ophthalmology2008; 115(8): 1279–85.
22.
FrenchANAshbyRSMorganIGRoseKA. Time outdoors and the prevention of myopia. Experimental Eye Research2013; 114: 58–68.
23.
JonesLASinnottLTMuttiDOMitchellGLMoeschbergerMLZadnikK. Parental history of myopia, sports and outdoor activities, and future myopia. Investigative Ophthalmology & Visual Science2007; 48(8): 3524–32.
24.
WuPCTsaiCLWuHLYangYHKuoHK. Outdoor activity during class recess reduces myopia onset and progression in school children. Ophthalmology2013; 120(5): 1080–5.
25.
MorganIGXiangFRoseKAChenQHeM. Two year results from the Guangzhou Outdoor Activity Longitudinal Study (GOALS). Presented at the Association for Research in Vision and Ophthalmology 2012, Fort Lauderdale, FL, 6–9 May 2012 (Abstract 2735).
26.
FeldkaemperMSchaeffelF. An updated view on the role of dopamine in myopia. Experimental Eye Research2013; 114: 106–19.
27.
CuiDTrierKMunk Ribel-MadsenS. Effect of day length on eye growth, myopia progression, and change of corneal power in myopic children. Ophthalmology2013; 120(5): 1074–9.
28.
SchmidKLLeydenKChiuYHLindSRVosDJKimlinM. Assessment of daily light and ultraviolet exposure in young adults. Optometry and Vision Science2013; 90(2): 148–55.
29.
CohenYBelkinMYehezkelOSolomonASPolatU. Dependency between light intensity and refractive development under light-dark cycles. Experimental Eye Research2011; 92: 40–6.
30.
SmithEL3rdHungLFHuangJ. Protective effects of high ambient lighting on the development of form-deprivation myopia in rhesus monkeys. Investigative Ophthalmology & Visual Science2012; 53(1): 421–8.
31.
MehdizadehMNowroozzadehMH. Outdoor activity and myopia. Ophthalmology2009; 116: 1229–30.
32.
CheckleyWRobinsonCLBaumannLMHanselNNRomeroKMPollardSL. 25-hydroxy vitamin D levels are associated with childhood asthma in a population-based study in Peru. Clinical and Experimental Allergy2015; 45(1): 273–82.
33.
ChoiJAHanKParkYMLaTY. Low serum 25-hydroxyvitamin D is associated with myopia in Korean adolescents. Investigative Ophthalmology & Visual Science2014; 55(4): 2041–7.
34.
YazarSHewittAWBlackLJMcKnightCMMountainJASherwinJC. Myopia is associated with lower vitamin D status in young adults. Investigative Ophthalmology & Visual Science2014; 55(7): 4552–9.
35.
FoucherAA. Myopia in its relations with scholastic hygiene. Public Health Papers and Reports1894; 20: 290–4.
36.
DavenportRC. Errors of refraction and their sequelæ. Postgraduate Medical Journal1934; 10(106): 283–7.
37.
FlitcroftDI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Progress in Retinal and Eye Research2012; 31(6): 622–60.
38.
LeoSWYoungTL. An evidence-based update on myopia and interventions to retard its progression. Journal of American Association for Pediatric Ophthalmology and Strabismus2011; 15: 181–9.
39.
WrightKPJrMcHillAWBirksBRGriffinBRRusterholzTChinoyED. Entrainment of the human circadian clock to the natural light-dark cycle. Current Biology2013; 23(16): 1554–8.
40.
VirchowR. On certain influences of schools injurious to health. Boston Medical and Surgical Journal1869; 81: 256–9.
41.
CohnH. Untersuchungen der Augen von 10,060 Schulkindern nebst Vorschlagen zur Verbesserung der den Augen nachtheiligen Schuleinrichtungen. Eine atiologische Studie. Leipzig: F. Fleischer, 1867.
42.
CohnH. Hygiene of the Eye in Schools. London: Simpkin, Marshall and Co., 1886.
43.
JacksonE. Suggestions as to ocular hygiene in the schools. Public Health Papers and Reports1895; 21: 141–8.
44.
IrwinRB. Sight-saving Classes in the Public Schools (Harvard Bulletins in Education No. VII). Cambridge, MA: Harvard University, 1920.
45.
HarmanNB. A paper on sight-saving classes. British Medical Journal1933; 1(3760): 129–32.
46.
BrannanJW. Open air schools – Present status and results observed in ten years’ experience. Transactions of the American Climatological and Clinical Association1921; 37: 117–35.
47.
HathawayW. A Manual for the Establishing and Conduct of Classes for the Conservation of Vision. New York: New York State Committee for the Prevention of Blindness, 1919.
48.
PooleD. Passive solar design – The local authority experience. International Journal of Ambient Energy1990; 11(1): 13–6.
49.
SorsbyA. The control of school myopia. British Medical Journal1933; 21; 2(3798): 730–3.
50.
SorsbyA. School myopia. British Journal of Ophthalmology1932; 16(4): 217–22.
51.
Ministry of Works. The Lighting of Buildings (Post-War Building Studies No. 12). London: HMSO, 1944.
52.
WuWNgE. A review of the development of daylighting in schools. Lighting Research and Technology2003; 35(2): 111–25.
53.
StrongEM. Proper school lighting. American Journal of Public Health1956; 46: 610–22.
54.
LyhneNSjølieAKKyvikKOGreenA. The importance of genes and environment for ocular refraction and its determiners: A population based study among 20–45 year old twins. British Journal of Ophthalmology2001; 85: 1470–6.
55.
EdwardsBW. Environmental design and educational performance, with particular reference to ‘green’ schools in Hampshire and Essex. Research in Education2006; 76: 14–32.
56.
NortonTTSiegwartJTJr. Light levels, refractive development, and myopia – A speculative review. Experimental Eye Research2013; 114: 48–57.
57.
Building Bulletin 87: Guidelines for Environmental Design in Schools (Revision of Design Note 17) Architects and Building Branch, Department for Education and Employment. London: The Stationery Office, 1997.
58.
StoneRAPardueMTIuvonePMKhuranaTS. Pharmacology of myopia and potential role for intrinsic retinal circadian rhythms. Experimental Eye Research2013; 114: 35–47.
59.
PhillipsJRBackhouseSCollinsAV. Myopia, light and circadian rhythms. In RumeltS (ed.) Advances in Ophthalmology. Croatia: Intech, 2012, pp. 141–66.
60.
FouldsWSBarathiVALuuCD. Progressive myopia or hyperopia can be induced in chicks and reversed by manipulation of the chromaticity of ambient light. Investigative Ophthalmology & Visual Science2013; 54(13): 8004–12.
61.
GuoYLiuLJXuLTangPLvYYFengY. Myopic shift and outdoor activity among primary school children: One-year follow-up study in Beijing. PLoS One2013; 8(9): e75260.
