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EW NEWS & OPINION July 2017 25 Editors' note: Dr. Sakiene has no finan- cial interests related to her comments. 5. Wu PC, et al. Outdoor activity during class recess reduces myopia onset and progres- sion in school children. Ophthalmology. 2013;120:1080–1085. illumination, longer hours spent studying per day, less rest during study time, a shorter duration of TV watching/computer time, and high- er protein intake. 2 Outcomes from another population-based study including 2,059 children demon- strated that children who became myopic spent less time outdoors and performed significantly more near work, compared to children who did not develop myopia. It showed a positive association with one or two myopic parents and a higher incidence in children of East Asian ethnicity compared to European. 3 In yet another study that involved 2,353 participants, myo- pia was not seen to be significantly associated with time spent engaged in near work, however, there were significant independent associations with factors like close reading and continuous reading. The outcomes suggested that near work intensity rather than the total duration of near work might be an important factor in myopia progression. 4 Finally, in 571 students who participated in an intervention- al analysis in which one school's population of children were given recess outside the classroom (n=333 children) while those from other schools without outdoor recess served as controls (n=238 children), the intervention was shown to have a significant effect on myopia onset and myopic shift. The inter- vention program and higher school year proved to be protective factors against myopic shift in non-myo- pic children, whereas for myopic children, school year was the only variable significantly associated with myopia progression. 5 EW References 1. Holden B, et al. Myopia, an underrated global challenge to vision: Where the current data takes us on myopia control. Eye (Lond). 2014;28:142–146. 2. You QS, et al. Factors associated with myopia in school children in China: The Beijing childhood eye study. PLoS One. 2012;7:e52668. 3. French AN, et al. Risk factors for incident myopia in Australian schoolchildren: The Sydney adolescent vascular and eye study. Ophthalmology. 2013;120: 2100–2108. 4. Ip JM, et al. Role of near work in my- opia: Findings in a sample of Australian school children. Invest Ophthalmol Vis Sci. 2008;49:2903–10. S:6.69" T:7.19" B:7.44" Contact information Sakiene: Sakiene.ruta@gmail.com