The incidence of myopia among school children has risen markedly over the last three decades. In urban areas of South and East Asia, as many as 80-90% of young adults are now myopic. This trend is occurring elsewhere around the world. During the COVID-19 lockdowns, children in many countries were confined indoors and spent an undue amount of time exposed to television screens, computers, and mobile devices. This resulted in an acceleration in the incidence and progression of the condition. Myopia is a significant public health issue as it is a leading cause of blindness and other vision problems. Yet the underlying mechanisms that produce the condition remain elusive. Pseudomyopia has recently been proposed as an independent risk factor for myopia. We hypothesize that pseudomyopia induced by prolonged close work, stress, and anxiety combines and is further amplified by chronically low ambient light levels. If time spent outdoors in daylight is restricted, the effects worsen and together may play a significant part in myopia epidemics.

Building Lighting Group Department of the Built Environment Eindhoven University of Technology Eindhoven Netherlands

Centre for Chronobiology Psychiatric Hospital of the University of Basel Basel Switzerland

Czech Technical University Prague University Centre for Energy Efficient Buildings Buštěhrad Czechia

Department of Molecular Biology Umeå University Umeå Sweden

Hobday Research Cwmbran United Kingdom

Lucerne School of Engineering and Architecture University of Applied Sciences and Arts Lucerne Switzerland

Research Cluster Molecular and Cognitive Neurosciences University of Basel Basel Switzerland

Strategic Real Estate Development Building Division Vicariate General of the Catholic Arch diocese of Paderborn Paderborn Germany

Wallenberg Centre for Molecular Medicine Umeå University Umeå Sweden

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