Setting outdoor time goals for managing nearsightedness

Set outdoor time goals to empower your child for more outdoor time and curb myopic progression.

As the new year unfolds, are you contemplating the resolutions to commit to this year? If you're a parent with a child dealing with nearsightedness (myopia), working with your child to set an outdoor time resolution may help protect their eye health.

Getting your child playing outdoors every day has a profound impact on your child's eye health. Research indicates that spending time outdoors and exposure to daylight can safeguard children against the progression of nearsightedness. A meta-analysis study revealed that engaging in more outdoor activities, approximately 14-15 hours per week, is comparably effective to some of the therapeutic interventions in slowing myopic progression.¹

The Refractive Errors Preferred Practice Pattern 2022 released by the American Academy of Ophthalmology underscores the importance of increased outdoor time, stating that studies indicated "increasing time spent outdoors significantly decreased risk of myopic progression."²

However, it may not be that simple. Motivating your child to persistently play outside for two hours every day can be challenging. In this article, we will explore how to establish a New Year resolution with your child—specifically, an outdoor time goal— helping them adhere to getting sufficient daylight for their eye health.

Two hours of outdoor time every day is challenging

Getting your child playing outside may sound simple and easily achievable. However, if you have tried to get your child to do it 365 days a year, may it be a dark winter day, a low-energy day, or a day that they have other planned afterschool activities that are indoors, you know it is not easy.  

Parents of children with nearsightedness face numerous obstacles when encouraging outdoor playtime. From a survey conducted in 2023, the key obstacles include conflicting schedules and after-school activities, the preference for digital devices and near-vision activities, weather-related barriers, and more.³

Furthermore, in many regions, the shorter daylight hours during the winter time, coupled with freezing temperatures, makes staying home inside the house a preferred and comfortable instinctive choice for any child. It's like a magnet pulling and keeping them from going out.

So, what can you do? While there are tips and tricks to overcome the inertia, let's have a deeper dive into one of the strategies – setting outdoor time goals.

Setting outdoor time goals could help

Establishing outdoor time goals can be beneficial, like setting fitness goals for a healthier lifestyle. Consider this: Have you ever committed to a New Year's resolution to exercise more, and if so, were you able to sustain it throughout the entire year? 

Those who have succeeded often attribute their achievement to setting specific fitness goals and adhering to them consistently. Similarly, when it comes to eye health and preventing the progression of nearsightedness, setting outdoor time goals can play a crucial role. Applying lessons learned from successful goal setting, we can adopt the following principles for establishing and maintaining outdoor goals:

• Relevance and importance: Engage in discussions to ensure your child understands how outdoor time is relevant to their eye health and why this is crucial.
• Objective measurement: Ensure that the measurement and tracking of outdoor time are conducted objectively and are easily carried out, allowing for accurate and reliable data. This can be efficiently achieved with a timer on a watch and tracked daily with a log.
• Personalized plans: Work with your child and create plans that integrate into your child's daily routine, enhancing the likelihood of sustained commitment. Resolve any potential time conflicts ahead of time. Discuss what to do when the weather is less than ideal.
• Positive reinforcement and rewards: Implement strategies for positive reinforcement to perpetuate the desired behavior change over the long term.

Setting up outdoor time goals with my son

1. Establish realistic and specific goals

Recognizing the recommended outdoor time is more than 8 to 15 hours per week,⁴ it's crucial to work with your child in setting achievable goals that take into account specific situations and external factors. For instance, during the winter months with shorter daylight hours, our goal was adjusted from an average of 120 minutes every day to approximately 85 minutes per day or around 45 hours in January. Checking sunrise and sunset times on websites like https://www.timeanddate.com/ helped us plan a realistic goal, considering factors like when my son gets back from school and available daylight time left.

2. Brainstorming when and what outdoor activities

Planning activities that are fun, preferably with playing friends, could help you and child succeed. Adjusting morning routines, like going to the school bus stop earlier, and facilitating play with schoolmates in the neighborhood after school are effective strategies. I’ve also got outdoor sporting equipment such as soccer balls, basketballs, baseballs, and frisbees to encourage his friends to join in and play with him. Weekends can involve more relaxed family outdoor activities like trekking, hiking, or visiting the zoo.

3. Agreeing on rewards

Reward can be a powerful motivator, particularly on days when the weather may not be favorable. Establishing a system where outdoor time leads to rewards helps cultivate the desire to achieve the goal. For instance, my son actively asked me to play with him outdoors at the end of last December instead of playing on his iPad to accumulate the hours he needed to earn his reward, demonstrating this approach could be very effective.

4. Use an outdoor activity tracker

Utilizing a tracker for goal evaluation is a practical strategy. Further, asking your child to track their outdoor time empowers them to take ownership of their outdoor time goals. We have used a paper-based outdoor activity tracker since starting the myopia control journey. Recently, my son has been using the MyoAssist app (Andriod version now available; iOS coming soon), allowing him to see his progress in more detail and encouraging him to work persistently toward his outdoor time goal. This positive shift is reflected in the aforementioned example.

(Note: Paper-based and app-based outdoor activity trackers are both near-work activities. After switching to the app-based tracker, he now spends less time on the tracker calculating the total outdoor time while getting more informative details about his progress and the amount of time left to achieve his set goal.)

Conclusion

In sum, as we welcome the new year, consider a unique resolution for this year—setting outdoor time goals with your child. Research has highlighted the significant impact of outdoor time in safeguarding eye health in children with nearsightedness. By navigating obstacles and strategically setting outdoor goals, you can empower your child to embrace more outdoor adventures and slow down their myopic progression. Here's to a year filled with outdoor fun and a vision of healthier eyes!

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1. Huang, Jinhai et al. “Efficacy Comparison of 16 Interventions for Myopia Control in Children: A Network Meta-analysis.” Ophthalmology vol. 123,4 (2016): 697-708. doi:10.1016/j.ophtha.2015.11.010.

2. Jacobs, Deborah S et al. “Refractive Errors Preferred Practice Pattern®.” Ophthalmology vol. 130,3 (2023): P1-P60. doi:10.1016/j.ophtha.2022.10.031

3. ClearSight Health. Data on File 2023.

4. Németh, János et al. “Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute.” European journal of ophthalmology vol. 31,3 (2021): 853-883. doi:10.1177/1120672121998960.