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A couple of years ago the Chinese government implemented a new policy that’s sparked conversations about childhood myopia and online gaming. Under the policy, Chinese children and teens under the age of 18 are only permitted to play online video games for one hour on weekend evenings and public holidays — a significant reduction compared to their previous online gaming allotment. This restriction includes all forms of video games, from handheld devices to computer and smartphone gaming.

The government hopes to combat a common condition called online gaming disorder, or video game addiction, which affects more than 30% of children in China. Another potential benefit of limiting online gaming may be a reduction in childhood myopia progression, something we explore below.

Myopia, or nearsightedness, is a condition that causes blurred distance vision. Several factors contribute to the onset and progression of myopia, including genetic and environmental.

Several studies have found that screen time, along with other forms of near work, is associated with higher levels of myopia and myopia progression in children.

According to a study published in the British Journal of Ophthalmology (2019), children who engage in screen time for more than 3 hours per day have almost 4 times the risk of becoming myopic. Younger children, around ages 6-7, are even more susceptible to experiencing screen-related nearsightedness, with 5 times the risk compared to children who don’t use digital screens.

Limiting screen time may also encourage children to spend more time outdoors in the sun, a protective factor against developing myopia and slowing its progression.

In The Sydney Adolescent Vascular and Eye Study (2013), researchers found that spending at least 21 hours outdoors per week was more important for delaying the onset of myopia than limiting near work in both younger and older children, although both were effective.

What’s the Bottom Line?

Although online gaming can give children a sense of community and togetherness, excessive online gaming can increase a child’s risk of developing myopia and contribute to its progression.

The good news is that parents can make eye-healthy choices for their children that can have lifelong benefits. Limiting near work activities like online gaming and other screen time, and encouraging your children to play outdoors can significantly reduce their chances of developing high (severe) myopia.

How Myopia Management Can Help

The best thing that parents can offer their children to prevent myopia and halt its progression is a custom-made myopia management treatment plan with an eye doctor.

Whether or not myopia has set in already, we can help preserve your child’s eye health and lower their risk of developing sight-threatening eye diseases like glaucoma, cataracts, macular degeneration and retinal detachment in the future.

Who is an ideal candidate for myopia management?

Children, teens, and young adults who are nearsighted or are at risk of becoming nearsighted are ideal candidates for myopia management. If you think myopia management is right for you or your child, speak with us about how we can help. Remember, the sooner your child starts myopia management, the better their outcome will be.

Is myopia management based on scientific evidence?

Increasing Prevalence of Myopia  

Vitale S, Sperduto RD, Ferris FL 3rd. Increased prevalence of myopia in the United States between 1971-1972 and 1999-2004. Arch Ophthalmol. 2009;127(12):1632-9. 

Neil Charman.(2010) Myopia: its prevalence, origins and control. Ophthalmic and Physiological OpticsVolume 31, Issue 1, pages 3–6, January 2011 (FULL TEXT) doi: 10.1111/j.1475-1313.2010.00808.x

Development of Myopia  

Xiang F, He M, Morgan IG. The impact of parental myopia on myopia in Chinese children:population-based evidence. Optom Vis Sci. 2012 Oct;89(10):1487-96..

Morgan IG, Ohno-Matsui K, Saw SM. Myopia. Lancet. 2012 May 5;379(9827):1739-48..  

Risks of Myopia

Klaver CW, et al  “Association of axial length with risk of uncorrectable visual impairment for europeans with myopia” JAMA Ophthalmol 2016; DOI: 10.1001/jamaophthalmol.2016.4009..

DANDONA, Rakhi and DANDONA, Lalit. Refractive error blindness. Bull World Health Organ [online]. 2001, vol.79, n.3.  

Paul Mitchell, et al., The relationship between glaucoma and myopia: The blue mountains eye study, Volume 106, Issue 10, 1 October 1999, Pages 2010–2015.

Myopia Control Options

Walline JJ, Lindsley K, Vedula SS, et al. Interventions to slow progression of myopia in children. Cochrane Database Syst Rev.2011 Dec 7;(12):CD004916. doi: 10.1002/14651858.CD004916.pub3..  

Cho P, Cheung SW, Edwards M. The longitudinal orthokeratology research in children (LORIC) in Hong Kong: a pilot study on refractive changes and myopic control. Curr Eye Res. 2005 Jan;30(1):71-80..

Walline JJ, Rah MJ, Jones LA. The Children’s Overnight Orthokeratology Investigation (COOKI) pilot study. Optom Vis Sci. 2004 Jun;81(6):407-13..  

Eiden SB, Davis RL, Bennett ES, DeKinder JO. The SMART study: background, rationale, and baseline results. Contact Lens Spectrum. 2009 Oct..

Kakita T, Hiraoka T, Oshika T. Influence of overnight orthokeratology on axial elongation in childhood myopia. Invest Ophthalmol Vis Sci. 2011 Apr 6;52(5):2170-4.