Light Exposure and Eye Growth in Childhood

PURPOSE: The purpose of this study was to examine the relationship between objectively measured ambient light exposure and longitudinal changes in axial eye growth in childhood. METHODS: A total of 101 children (41 myopes and 60 nonmyopes), 10 to 15 years of age participated in this prospective longitudinal observational study. Axial eye growth was determined from measurements of ocular optical biometry collected at four study visits over an 18-month period. Each child's mean daily light exposure was derived from two periods (each 14 days long) of objective light exposure measurements from a wrist-worn light sensor. RESULTS: Over the 18-month study period, a modest but statistically significant association between greater average daily light exposure and slower axial eye growth was observed (P = 0.047). Other significant predictors of axial eye growth in this population included children's refractive error group (P < 0.001), sex (P < 0.01), and age (P < 0.001). Categorized according to their objectively measured average daily light exposure and adjusting for potential confounders (age, sex, baseline axial length, parental myopia, nearwork, and physical activity), children experiencing low average daily light exposure (mean daily light exposure: 459 ± 117 lux, annual eye growth: 0.13 mm/y) exhibited significantly greater eye growth than children experiencing moderate (842 ± 109 lux, 0.060 mm/y), and high (1455 ± 317 lux, 0.065 mm/y) average daily light exposure levels (P = 0.01). CONCLUSIONS: In this population of children, greater daily light exposure was associated with less axial eye growth over an 18-month period. These findings support the role of light exposure in the documented association between time spent outdoors and childhood myopia.