For years, rising rates of myopia – or nearsightedness – have been widely attributed to increased screen time, especially among children and young adults. But new research from scientists at the\u202fSUNY College of Optometry\u202fsuggests the story may be more complicated – and more human.\u00a0In a new study to be published in\u202fCell Reports, researchers propose that myopia may be driven less by screens themselves and more by a common indoor visual habit: prolonged close-up focus in low-light environments, which limits how much light reaches the retina.\u00a0<\/p>\n
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Myopia has reached near-epidemic levels worldwide, yet we still don’t fully understand why. Our findings suggest that a common underlying factor may be how much light reaches the retina during sustained near work – particularly indoors.”\u00a0<\/p>\n
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Jose-Manuel Alonso, MD, PhD, SUNY Distinguished\u00a0Professor and senior author of the study<\/p>\n
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Myopia (nearsightedness) is a visual disease that blurs vision at far distance and is becoming a world epidemic\u00a0affecting\u00a0nearly 50 percent\u00a0of young adults in the United States and Europe and close to 90 percent in parts of East Asia. While genetics play\u00a0an important role, rapid increases over just a few generations suggest environmental factors are also critical.\u00a0<\/p>\n
The disease can be induced in animal models with visual deprivation or negative lenses, and the two induction processes are thought to involve different neuronal mechanisms. Clinicians also control myopia progression with\u00a0a variety of\u00a0approaches that are thought to engage multiple mechanisms (multifocal lenses, ophthalmic atropine, contrast-reduction, promoting time outdoors, and others).\u00a0Scientists at the State University of New York (SUNY) College of Optometry propose a unifying neuronal mechanism\u00a0in their article\u00a0to explain all current approaches to myopia induction and control.\u00a0<\/p>\n
The research offers a new hypothesis that could help explain a long-standing puzzle in vision science – why so many\u00a0seemingly different\u00a0factors, from near work and dim indoor lighting to treatments like atropine drops, multifocal lenses, and time spent outdoors, all\u00a0appear to influence\u00a0myopia progression.\u00a0<\/p>\n
“In bright outdoor light, the pupil constricts to protect the eye while still allowing ample light to reach the retina,” explains\u00a0Urusha Maharjan, SUNY Optometry doctoral student\u00a0who conducted the study.\u00a0“When people focus on close objects indoors, such as phones, tablets, or books, the pupil can also constrict, not because of brightness, but to sharpen the image. In dim lighting, this combination may significantly reduce retinal illumination.”\u00a0<\/p>\n
According to this mechanism, myopia develops when poor retinal illumination\u00a0fails to\u00a0generate robust retinal activity because the light sources are too\u00a0dim\u00a0and pupil constriction is too excessive at short viewing distances. Conversely, myopia does not develop when the eye is exposed to bright\u00a0light\u00a0and the pupil constriction is regulated by image brightness instead of viewing distance.\u00a0<\/p>\n
The new study\u00a0demonstrates\u00a0that negative lenses reduce retinal illumination by constricting the pupil through a process known as accommodation (i.e.,\u00a0an accommodative increase in the lens power of the eye when focusing images at short distances). Such pupil constriction becomes stronger when accommodation is increased by shortening viewing distance or wearing\u00a0excessively-strong\u00a0negative lenses. Moreover, pupil constriction becomes even stronger when lens accommodation is sustained for prologued periods of time (e.g.,\u00a0tens of minutes), and even stronger when the eye becomes myopic. The study also\u00a0demonstrates\u00a0additional\u00a0myopia disruptions of eye turning with accommodation and eye-blink efficacy<\/a> at constricting the pupil.\u00a0<\/p>\n If proven correct, the mechanism proposed could lead to\u00a0a paradigm shift\u00a0in our understanding of myopia progression and control. According to this mechanism, myopia can be controlled by exposing the eye to safe bright light levels under limited accommodative pupil constriction. Accommodative pupil constriction can be limited by reducing accommodation strength with lenses (multifocal or contrast-reduction), blocking directly the muscles driving pupil constriction (atropine drops), or by simply spending time outdoors without engaging accommodation (looking at far distances).\u00a0<\/p>\n Perhaps most\u00a0importantly, the new mechanism predicts that any approach to myopia control will fail if the eye is exposed to excessive accommodation indoors under low light for prolonged periods of time.\u00a0<\/p>\n “This is not a final answer,” Alonso emphasized. “But the study\u202foffers a testable hypothesis that reframes how visual habits, lighting, and eye focusing interact.\u00a0It’s\u00a0a hypothesis grounded in measurable physiology that brings together many pieces of existing evidence. More research is needed, but it gives us a new way to think about prevention and treatment.”\u00a0<\/p>\n The research was done by Urusha Maharjan and collaborators in the laboratories of Jose-Manuel Alonso at the SUNY College of Optometry. It will be published on\u00a0February 17,\u00a02026\u00a0at\u00a011:00 am\u00a0(Eastern Time) in Cell Reports (notice: press embargo will be lifted on this date and time).\u00a0<\/p>\n Source:<\/p>\n State University of New York College of Optometry<\/a><\/p>\n Journal reference:<\/p>\n