Behavioral factors contribute to the development of myopia
Extensive empirical research, including longitudinal and systematic reviews, consistently demonstrates that behavioral factors such as prolonged near work, high screen time, and limited outdoor activity significantly contribute to the development and progression of myopia in children.
The claim asserts that behavioral factors contribute to the development of myopia. Multiple provided sources (such as observational studies, large-scale cohorts, and systematic reviews like papers 0, 1, 2, 3, 5, 7, 8, and 10) explicitly report significant associations between modifiable behaviors like near work, reading hours, screen time, and a lack of outdoor activity with myopia incidence and progression. No papers refute this well-established relationship. Therefore, the balance verdict is SUPPORTED.
R. Saxena, P. Vashist, R. Tandon, R. Pandey, Amit Bhardawaj, Vivek Gupta, V. Menon. Incidence and progression of myopia and associated factors in urban school children in Delhi: The North India Myopia Study (NIM Study). 2017. https://doi.org/10.1371/journal.pone.0189774
Paper [0] found that hours of reading-writing and screen time are significant risk factors for myopia progression.
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Neeraj K Singh, Ritika M James, Avdhesh Yadav, Rishikesh Kumar, S. Asthana, S. Labani. Prevalence of Myopia and Associated Risk Factors in Schoolchildren in North India.. 2019. https://doi.org/10.1097/OPX.0000000000001344
Paper [1] showed a positive association between myopia and excessive study hours and video game usage.
Siddharth K Karthikeyan, DL Ashwini, M Priyanka, Anush Nayak, Sayantan Biswas. Physical activity, time spent outdoors, and near work in relation to myopia prevalence, incidence, and progression: An overview of systematic reviews and meta-analyses. 2022. https://doi.org/10.4103/ijo.ijo_1564_21
Paper [2] concluded from systematic reviews that near work is related to the risk of myopia and outdoor time is protective.
Carla Lanca, Jason C. Yam, Wen‐Jun Jiang, Yih‐Chung Tham, Mohammad Hassan Emamian, Chuen‐Seng Tan, Yin Guo, Hu Liu, Hua Zhong, Dan Zhu, Yuan‐Yuan Hu, Rohit Saxena, Hassan Hashemi, Li‐Jia Chen, Tien‐Yin Wong, Ching‐Yu Cheng, Chi‐Pui Pang, Hui Zhu, Chen‐Wei Pan, Yuan Bo Liang, Akbar Fotouhi, Hong‐sheng Bi, Jost B. Jonas, Seang‐Mei Saw. Near work, screen time, outdoor time and myopia in schoolchildren in the Sunflower Myopia AEEC Consortium. 2021. https://doi.org/10.1111/aos.14942
Paper [3] demonstrated that increased reading, writing, and less outdoor time are associated with myopia in schoolchildren.
Aparna Gopalakrishnan, Jameel Rizwana Hussaindeen, Viswanathan Sivaraman, Meenakshi Swaminathan, Yee Ling Wong, James A. Armitage, Alex Gentle, Simon Backhouse. Myopia and Its Association with Near Work, Outdoor Time, and Housing Type among Schoolchildren in South India. 2023. https://doi.org/10.1097/opx.0000000000001975
Paper [5] highlighted that the near-work to outdoor time ratio and outdoor time are strongly associated with myopia development.
J. Yam, X. Zhang, Ebenezer Zaabaar, Yuyao Wang, Yuelan Gao, Yuzhou Zhang, Xiaotong Li, K. Kam, F. Tang, Wai Kit Chu, Xiangtian Zhou, Wei Zhang, Xiangui He, Pei-Chang Wu, Kathryn Rose, Ian Morgan, Mingguang He, Kyoko Ohno-Matsui, J. Jonas, Mingzhi Zhang, Clement C. Tham, L. Chen, C. Pang. Interventions to Reduce Incidence and Progression of Myopia in Children and Adults.. 2025. https://doi.org/10.1016/j.preteyeres.2025.101410
Paper [7] noted that a high-risk lifestyle and less outdoor time require rigorous interventions against myopia progression.
Pärssinen O. Factors associated with the high prevalence of myopia and its decrease-A historical review.. 2025. https://doi.org/10.1111/aos.70001
Paper [8] discussed historical and recent studies linking close-up strain from schooling and near work to high myopia prevalence.
Wance Wang, Jiahao Gong, Lei Yan, Bowen Xu, Yanqun Shi, Renkai Ge. Lifestyle and environmental risk factors for myopia in children: Evidence from a large-scale cross-sectional study in Shandong, China. 2026. https://doi.org/10.1371/journal.pone.0342658
Paper [10] identified behavioral risk factors such as prolonged screen exposure, heavy homework burdens, and improper reading habits as significant contributors to myopia.
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