Effect of Classroom Illuminance on the Development and Progression of Myopia in School Children
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Purpose: To evaluate the effect of classroom illuminance on the development and progression of myopia in elementaryschool children. Methods: The daylight factor, a ratio of inside and outside illuminance, was obtained in 50 elementary schools. The firstgradestudents in the school with the lowest daylight (LD) factor (LD school, 145 subjects; 0.51%) and with the highest daylight(HD) factor (HD school, 147 subjects; 13.35%) were selected. A survey was conducted to evaluate parental myopia, theamount of near-work and outdoor activities. The refractive error and axial length (AL) were measured at initial and after 6months. The spherical equivalent, AL, and the survey results were compared between the two schools. The mean AL of theemmetropic children was obtained, and all subjects were divided into two groups, more and less than mean AL. Changes inrefractive errors and AL were also compared according to AL. Results: The amount of change in spherical equivalent and AL after 6 months were not different between the two schools. Initial prevalence of myopia was high in the HD school. However, it became similar between the two schools after 6 months. The mean AL of 155 emmetropic children was 22.7 ± 0.63 mm. In the 185 children with AL ≥22.7 mm, there was no differencein the AL change between the two schools. However, the change in AL in 107 children with AL <22.7 mm was significantlylarger in the LD school (0.19 mm) than that in the HD school (0.15 mm, p = 0.049). Parental myopia, near-work and outdooractivities were not different between the two schools. Conclusions: High classroom illuminance during the day reduced axial elongation in eyes of children with a shorter AL. Increasein classroom light level by permitting more sunlight can be a protective measure against the development of myopia.
Abstract
Purpose: To evaluate the effect of classroom illuminance on the development and progression of myopia in elementaryschool children. Methods: The daylight factor, a ratio of inside and outside illuminance, was obtained in 50 elementary schools. The firstgradestudents in the school with the lowest daylight (LD) factor (LD school, 145 subjects; 0.51%) and with the highest daylight(HD) factor (HD school, 147 subjects; 13.35%) were selected. A survey was conducted to evaluate parental myopia, theamount of near-work and outdoor activities. The refractive error and axial length (AL) were measured at initial and after 6months. The spherical equivalent, AL, and the survey results were compared between the two schools. The mean AL of theemmetropic children was obtained, and all subjects were divided into two groups, more and less than mean AL. Changes inrefractive errors and AL were also compared according to AL. Results: The amount of change in spherical equivalent and AL after 6 months were not different between the two schools. Initial prevalence of myopia was high in the HD school. However, it became similar between the two schools after 6 months. The mean AL of 155 emmetropic children was 22.7 ± 0.63 mm. In the 185 children with AL ≥22.7 mm, there was no differencein the AL change between the two schools. However, the change in AL in 107 children with AL <22.7 mm was significantlylarger in the LD school (0.19 mm) than that in the HD school (0.15 mm, p = 0.049). Parental myopia, near-work and outdooractivities were not different between the two schools. Conclusions: High classroom illuminance during the day reduced axial elongation in eyes of children with a shorter AL. Increasein classroom light level by permitting more sunlight can be a protective measure against the development of myopia.
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