Myopia Management PERSPECTIVES

Assessing online health education to prevent myopia

Effects of Online Family Health Education on Myopia Prevention in Children by Parental Myopia

Paper authors: Jiayu Zhang, Lili Wang, Lan Guo, Yangfeng Guo, Feng Zhao, Yin Hu, Qian Li, Xueying Du, Xueqing Deng, Nali Deng, Xiao Yang, Ciyong Lu.

This study assessed the impact of weekly online family health education messages which promoted outdoor activities, good eye habits, and limited screen time. It specifically examined how this approach may affect myopia prevention in children, stratified by parental myopia.

What the Research Showed

The researchers conducted a cluster-randomized trial involving children in their first and second years of formal schooling (mean age of 6.8 years) from 12 primary schools in Guangzhou, China. Parents in the intervention group received weekly online family health education messages, while the control group did not receive such communication. The study followed the children for three years.


Effects on Children with Non-Myopic Parents

The results revealed that for children with non-myopic parents, the 3-year cumulative incidence rate of myopia in the intervention group was significantly lower than in the control group. However, when considering the entire study groups (both myopic and non-myopic parents), there were no significant differences in myopia incidence and myopia change between the intervention and control groups. Additionally, the mean myopic change in spherical equivalent refraction for the children with non-myopic parents was less in the intervention group compared to the control group.


Outdoor Engagement and Myopia Prevention

This randomized clinical trial contributes valuable insights into the effectiveness of online family health education for myopia prevention and emphasizes the significance of parental involvement in promoting healthy eye habits in children. The study demonstrated the importance of increasing outdoor activities as a myopia prevention measure for children. However, it also found that additional messaging had limited impact on children with myopic parents. Results showed that parents without myopia in the intervention group arranged more frequent family outdoor activities than the control group. Conversely, for parents with myopia, the intervention group focused on limiting their children’s screen time, but there was no significant difference in parental attitudes toward outdoor activities or outdoor time for children compared to the control group. This finding may be attributed to parental attitudes towards outdoor activities and screen time, which could influence the children’s visual behaviour and habits; specifically, myopic parents tend to place a higher emphasis on education and may be more cautious about their children’s outdoor activities due to concerns about a detrimental impact on academic performance. The observed differences in the effectiveness of the intervention between children with myopic and non-myopic parents raise intriguing questions about the role of genetic factors in myopia prevention. Genetic predisposition has been established as a crucial risk factor for myopia development, and parental myopia is considered a significant predictor of myopia in children. The results indicate that genetic factors may interact with environmental influences, such as outdoor time, in influencing the development and progression of myopia.

Key Takeaways for Practising Eye Care Professionals

Adult female doctor ophthalmologist checking eye vision of young girl in modern clinic
  • The effectiveness of online family health education appears to vary depending on whether parents have myopia.
  • Children with non-myopic parents benefited more from the intervention (weekly messaging about family health education), experiencing a lower incidence of myopia and reduced myopic shift in refractive error.
  • Online family health education can influence parental attitudes and behaviours related to myopia prevention in children. It can lead to positive changes in limiting screen time and encouraging outdoor activities.

Three Action Items for Practising Eye Care Professionals

  1. Implement regular eye examinations for children, especially those with myopic parents, to detect myopia early and take appropriate preventive measures.
  2. Educate parents about the benefits of increased outdoor activities for their children’s eye health and overall well-being.
  3. Provide parents with practical tips and resources for managing screen time and creating a healthy visual environment for their children.

For the full-length article, please visit here.

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Prepared by the World Council of Optometry Myopia Management Resource Committee 2023.
The World Council of Optometry Myopia Management Standard of Care initiative is a collaborative partnership between World Council of Optometry and CooperVision.

Soft Dual Focus or Multifocal Contact Lenses

Spectacle Lenses for Myopia Control



When to wear it

Children who are physically active
Ideal for very young wearers
Children disliking glasses and/or inclined to not wearing them full-time


Shown to improve confidence and ability to participate in activities.

Typically more availability for astigmats.

No wearing time during waking hours.

Optical correction is still needed.

* Excluding children frequently engaged in water sports.