The development of Myopia has been linked to multiple factors. Currently, the association between Myopia and near visual activities is concerning. The visual demand for concentrating on close-up tasks such as reading and studying is increasing in school. The increased engagement of young children in near visual activities is thought to be a driving force for Myopia and progressive Myopia in children.

A systematic review showed that near visual activities were associated with Myopia. The increased ‘dioptre-hours’ of near work might increase the prevalence of Myopia. The findings of the review suggest that more time spend on near visual activities was associated with higher odds of Myopia (OR = 1.14 or a 14% increased chance) and that the odds of Myopia increased by 2% for every one dioptre-hour more of near work per week.

Moreover, the impact of near visual activity could be more cumulative over time and various factors such as lighting conditions and frequency of break and break times from near work can influence the risk of Myopia. A school-based cross-sectional study revealed that an early age of schooling, prolonged near work, and short working distances in addition to lack of outdoor sports activities were significantly associated with the risk of Myopia in primary school children.

The correction of the Myopia evaluation trial among 469 children revealed that reduction in visual activity might potentially be associated with stabilization of Myopia by age. Reducing near visual activity and increasing the time spent outdoors might serve as a simple strategy for reducing developing Myopia in children and adolescents. A study by Ip et al. suggested that reading distance and the amount of continuous reading without a break are important factors rather than the total amount of time spent on reading.

Any form of near visual activity such as reading, sitting too close to your computer screen, or spending too many hours crafting is a major contributor to Myopia. A nationwide 4-year follow-up study revealed that increased near visual activity or reduced time outdoors was associated with the risk of Myopia. Cram school attendance for more than 2 hours/ day had an increased risk of incident Myopia. The strain exerted on the eyes during near visual activity for prolonged periods increases the risk of early-onset Myopia in children.

It is recommended for children to limit the hours spent on close tasks and screen time whenever feasible without affecting schooling. While engaging in near visual activities, children should be encouraged to take frequent breaks.

Following are some tips based on research:

- Encourage more balance in the lifestyle of the children by considering how much time they spend on school work, reading, studying, and the outdoors.
- Restrict the prolonged use of digital devices and screens, especially outside school work.
- Teach your children the 20-20-20 rule and encourage them to use it frequently any time they are doing near visual activity¹. This means every 20 minutes, your child should focus their eyes on an object 20 feet away for 20 seconds to protect their vision.
- Taking some time away from near visual activities can help to maintain overall eye health and vision among your children.