Evidence map›Paper›PMID 38010695›Full record

ArticleInvestigative ophthalmology & visual science2023

Time Spent Outdoors Partly Accounts for the Effect of Education on Myopia.

Rosie Clark, Sander C M Kneepkens, Denis Plotnikov, Rupal L Shah, Yu Huang, J Willem L Tideman, Caroline C W Klaver, Denize Atan, Cathy Williams, Jeremy A Guggenheim and 1 more

Open access · goldAbstract read
In one paragraph

Article in Investigative ophthalmology & visual science, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 3 pooled it
4.9field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 23 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Effect of full spectrum indoor lighting on myopia progression in school-aged children: a prospective cohort study.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
    Article
  5. Review
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  8. Article
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  10. Identifying and Managing Pre-Myopia: A Narrative Review.Clinical ophthalmology (Auckland, N.Z.) · 2026
    Review
  11. Article
  12. Article
  13. Article
  14. IMI-Myopia Genetics Report.Investigative ophthalmology & visual science · 2025
    Review
  15. Article
  16. IMI-2025 Digest.Investigative ophthalmology & visual science · 2025
    Article
  17. Article
  18. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 6 countries.

Rosie ClarkSchool of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom.
Sander C M KneepkensDepartment of Ophthalmology, Erasmus University Medical Center, CA Rotterdam, The Netherlands.
Denis PlotnikovCentral Research Laboratory, Kazan State Medical University, Kazan, Russia.
Rupal L ShahPopulation Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, International Centre for Life, Central Parkway, Newcastle upon Tyne, United Kingdom.
Yu HuangGuangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
J Willem L TidemanDepartment of Ophthalmology, Erasmus University Medical Center, CA Rotterdam, The Netherlands.
Caroline C W KlaverDepartment of Ophthalmology, Erasmus University Medical Center, CA Rotterdam, The Netherlands.
Denize AtanTranslational Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS81NU, United Kingdom.
Cathy WilliamsCentre for Academic Child Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS81NU, United Kingdom.
Jeremy A GuggenheimSchool of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom.
UK Biobank Eye and Vision Consortium
ORCID · USErasmus MC · NLUniversity of Bristol · GBCentre for Life · GBKazan State Medical University · RURadboud University Nijmegen · NL

Funding

Medical Research Council G9815508Medical Research Council MC_PC_15018Medical Research Council MC_PC_19009Wellcome Trust
6 · The paper itself

Abstract

Purpose: The purpose of this study was to investigate if education contributes to the risk of myopia because educational activities typically occur indoors or because of other factors, such as prolonged near viewing. Methods: This was a two-sample Mendelian randomization study. Participants were from the UK Biobank, Avon Longitudinal Study of Parents and Children, and Generation R. Genetic variants associated with years spent in education or time spent outdoors were used as instrumental variables. The main outcome measures were: (1) spherical equivalent refractive error attained by adulthood, and (2) risk of an early age-of-onset of spectacle wear (EAOSW), defined as an age-of-onset of 15 years or below. Results: Time spent outdoors was found to have a small genetic component (heritability 9.8%) that tracked from childhood to adulthood. A polygenic score for time outdoors was associated with children's time outdoors; a polygenic score for years spent in education was inversely associated with children's time outdoors. Accounting for the relationship between time spent outdoors and myopia in a multivariable Mendelian randomization analysis reduced the size of the causal effect of more years in education on myopia to -0.17 diopters (D) per additional year of formal education (95% confidence interval [CI] = -0.32 to -0.01) compared with the estimate from a univariable Mendelian randomization analysis of -0.27 D per year (95% CI = -0.41 to -0.13). Comparable results were obtained for the outcome EAOSW. Conclusions: Accounting for the effects of time outdoors reduced the estimated causal effect of education on myopia by 40%. These results suggest about half of the relationship between education and myopia may be mediated by children not being outdoors during schooling.

Indexed as

Leisure ActivitiesMyopiaAdolescentChildEducational StatusHumansLongitudinal StudiesMendelian Randomization AnalysisRisk FactorsYoung Adult

Identifiers

PMID38010695
PMCPMC10683767
OpenAlexW4389057447

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.