Environmental and Behavioral Factors with Refractive Error in Israeli Boys

Abstract

SIGNIFICANCE Evidence supporting the contributions of near work in myopia is equivocal. Findings from this pilot study suggest that a high prevalence of myopia in ultra-Orthodox boys may be attributed to intense near work at school and learning to read in preschool at an early age. PURPOSE This study aimed to assess factors that may influence myopia in three groups of Jewish boys with different educational demands. METHODS Healthy ultra-Orthodox, religious, and secular Jewish boys (n = 36) aged 8 to 12 years participated. Refractive status, education, time spent reading and writing, and electronic device use were assessed using a questionnaire, and time outdoors and physical activity were assessed objectively using an Actiwatch. Data were analyzed with χ2 and Kruskal-Wallis tests with Bonferroni post hoc comparisons. RESULTS Ultra-Orthodox (n = 14) and religious (n = 13) children had greater myopia prevalence compared with secular children (n = 9; P =.01), despite no differences in parental myopia. Actigraph data showed that there were no differences in activity (P =.52) or time spent outdoors (P =.48) between groups. Ultra-Orthodox children learned to read at a younger age and spent more hours at school (P