Aim: To investigate the relationship of outdoor activities and myopia in Singapore teenage children. Methods: Teenage children (1249 participants), examined in the Singapore Cohort study Of Risk factors for Myopia (SCORM), during 2006 were included in analyses. Participants completed questionnaires that quantified total outdoor activity, and underwent an eye examination. Results: The mean total time spent on outdoor activity was 3.24 h/day. The total outdoor activity (h/day) was significantly associated with myopia, odds ratio 0.90 (95% CI 0.84 to 0.96) (p = 0.004), after adjusting for age, gender, ethnicity, school type, books read per week, height, parental myopia, parental education and intelligence quotient. In addition, the total time spent outdoors was associated with significantly less myopic refraction (regression coefficient = 0.17; CI 0.10 to 0.25, p<0.001) and shorter axial length (regression coefficient −0.06 (CI −0.1 to −0.03, p<0.001). Total sports was also significantly negatively associated with myopia (p = 0.008) but not indoor sports (p = 0.16). Conclusions: Participants who spent more time outdoors were less likely to be myopic. Thus, outdoor activity may protect against development of myopia in children, supporting recent Australian data. As near work did not predict outdoor activity, this can be viewed as an independent factor and not merely the reciprocal of near work.

Purpose. To determine the incidence and progression rates of myopia in young Singaporean children. methods. A prospective cohort study, the Singapore Cohort Study of the Risk Factors for Myopia (SCORM), was conducted in two schools in Singapore (1999–2002). Children aged 7 to 9 years (n = 981) were followed up over a 3-year period. Cycloplegic autorefraction and biometry parameter measures were performed annually, according to the same protocol. results. The 3-year cumulative incidence rates were 47.7% (95% confidence interval [CI]: 42.2–53.3), 38.4% (95% CI: 31.4–45.4), and 32.4% (95% CI: 21.8–43.1) for 7-, 8-, and 9-year-old children, respectively. The 3-year cumulative incidence rates were higher in Chinese (49.5% vs. 27.2%) and in 7-year-old compared with 9-year-old children at baseline (47.7% vs. 32.4%), though the latter relationship was of borderline significance after adjustment for race, gender, amount of reading (books/week), and parental myopia (P = 0.057). Premyopic children with greater axial lengths, vitreous chamber depths, and thinner lenses were more prone to the development of myopia, after controlling for age, gender, race, reading, and parental myopia. The 3-year mean cumulative myopia progression rates were −2.40 D (95% CI: −2.57 to −2.22) in 7-year-old myopic children, −1.97 (95% CI: −2.16 to −1.78) in 8-year-olds, and −1.71 (95% CI: −1.98 to −1.44) in 9-year-olds. conclusions. Both the incidence and progression rates of myopia are high in Singaporean children.