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A. Fozailoff, D. Oh, R. Varma, Multi-Ethnic Pediatric Eye Study Group; Active and Inactive Outdoor Play and Refractive Error in Preschool Children: The Multi-Ethnic Pediatric Eye Disease Study (MEPEDS). Invest. Ophthalmol. Vis. Sci. 2010;51(13):2969.
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To evaluate the association between active and inactive outdoor play with refractive error in a population-based sample of preschool children.
A population-based sample of African-American, Hispanic, and Non-Hispanic White children aged 6-72 months were evaluated. The children underwent a comprehensive eye examination including cycloplegic Retinomax autorefraction. Medical, perinatal, and socio-economic histories were determined from a detailed parental questionnaire. A detailed outdoor activity questionnaire was filled out by a subsample of the study population to assess the time spent in active and inactive play. Outdoor play was measured as average number of hours spent per week outdoors in active (riding bikes, running, etc.) and inactive play (sand box, crafts, sit down games, etc.). Linear regression analyses were used to assess the relationship between weekly hours of active and inactive outdoor play and magnitude of refractive error.
In the 1136 children included in this analysis, 337 of the children had 0 to <3 hours/week (low) of outdoor active play, 381 children had 3 to 12.5 hours/week (moderate), and 378 had 12.5+ hours/week (high). The mean refractive error in children with low, moderate, and high duration of active outdoor play was +1.13 diopters (D), +1.29 D, and +1.32 D, respectively. This association between higher duration of active outdoor play and lower levels of myopic refractive error was significant even after adjusting for age, gender, race and parental use of refractive correction (p=0.009). Outdoor inactive play was not significantly associated with lower levels of myopic refractive error.
Greater duration of active outdoor play was found to be associated with lower levels of myopia in preschool children. The presence of this relationship even in preschool children suggests that the impact of active outdoor play starts early in life and public health interventions aimed at reducing myopia should include this population.
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