We Can’t Manage 2 Hours of Outdoor Time Daily, But These Strategies Kept the Axial Length in Check

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Children’s vision is something that parents are increasingly focusing on.

Whether for short-term “convenience in life” — I myself have a high myopia of 600 degrees, and every time I go to the barber’s shop, it’s like opening a blind box, and I don’t make a sound;

Or for future “eye health” — ever since I learned about the risk of retinal detachment from high myopia, I have become more justified in not riding roller coasters.

In short, we all hope that our children’s myopia comes later, and even later; even if they are already myopic, we hope that the degree increases more slowly, and slower!

However, the idea is firm, but in the implementation process, there will always be a lot of resistance! Like our child, who has been nearsighted for four years,has always been in a basically “zero outdoor” state……(please go easy on us)

We rely on “technology and hard work”to control the degree.

First, let’s briefly explain “outdoor”. On the road to myopia prevention and control, responsible ophthalmologists will repeatedly emphasize its importance:

Increasing outdoor time by an additional 60 to 80 minutes per day can reduce the risk of myopia development by 45% to 50%. Based on this, it is recommended to engage in outdoor activities for at least 2 hours a day, which is more effective in preventing myopia.Further Reading: It’s Common Knowledge That Outdoor Activities Can Prevent Myopia, But Most People Are Doing It Wrong

But just like the saying that circulates online – “The group that least follows medical advice is doctors themselves” – even though I understand the importance of myopia prevention and control, our sixth-grade elementary school student is basically “zero outdoor”. The child is more of a homebody and doesn’t like to go out.

But mainly it’s our parents’ “fault”, we adults also don’t like to go out (here we sincerely accept criticism from netizens) .

I still remember when I first took my child to have their vision checked 4 years ago, the ophthalmologist Gui Sifeng, after understanding our living habits shook her head , just like a tutoring teacher encountering a “poor student” with very bad study habits.

Fortunately, while Dr. Gui was speechless, she also racking her brains to give us “make-up lessons” : fromAtropine Eye Dropsto Defocus Soft Lenses MiSight , later also interspersed with Star Interest Control, Reversal Shots.

As a “poor student”, these past few years, every 3 months of ophthalmology follow-up visits for us are like exams, to see how the “make-up lessons” are doing, whether the degree has increased, and how the eye axis is.(See below)

Three weeks ago, we just went through an ophthalmology “quiz”, and I was very embarrassed to tell Dr. Gui: “It’s still zero outdoor, and the child studies too hard, and the time spent relaxing on the tablet on weekends has increased… “

Unexpectedly! The “report card” came out, and it was actually not bad! Compared to 3 months ago, the eye axis didn’t grow at all!

In the past year , under high-intensity eye use, the total increase in the eye axis ofboth eyes is only 0.11/0.04mm!

This result may not mean much to parents who are used to “chicken” outdoors (and may not be ideal) , but for us “poor students” with bad habits, we are already very satisfied!

Dr. Gui also said that our family situation is actually quite representative, and she can understand that children are under a lot of study pressure now, the burden of homework is heavy, and parents are short of time (here we sincerely accept criticism from netizens) . Two hours of outdoor activities every day is really an overly idealistic and hard-to-reach requirement. Fortunately, there are more and more scientific methods for myopia prevention and control, and parents don’t actually have to be too anxious about “beating themselves up” over outdoor activities.

I hope my family’s experience can provide some reference and help to more parents.

When did the child become nearsighted?

How was it discovered?

Our first visit to the ophthalmologist was on December 18, 2021.

At that time, the child did not have any eye discomfort, had already started primary school, and could see the blackboard clearly from the last row. The reason for taking the child to the ophthalmologist was more out of the concept of “scientific parenting”: children should establish an optometry file and regularly monitor the development of the eye axis.

It just so happened that we welcomed the first ophthalmologist to the clinic – Dr. Gui Sifeng, and with the mentality of “first ophthalmology experience”, we took the child to have a look.

While the child was being examined, I was calculating how much of her hyperopia reserve was left, and I didn’t expect the result to be devastating: The child who has never complained about “not being able to see clearly” has already become nearsighted——

• Right eye 1.0

• Left eye 0.8-

The re-examination and retinoscopy results came out: there was no dramatic reversal, the child is indeed nearsighted, and the conditions of both eyes are quite different, the right eye is not myopic for the time being, and the left eye is 50 degrees myopic.

Dr. Gui analyzed the child’s daily routine and study posture and concluded that the large difference in degrees between the two eyes is likely related to writing with a tilted head .

“Technology and Hard Work” –

Atropine Eye Drops, MiSight Defocus Soft Lenses

After discovering myopia, Dr. Gui’s initial suggestion was:

• Correct posture;

• Try to strengthen outdoor activities;

• Prescribing glasses for the left eye, which can not only make the child see more clearly but more importantly control the progression of myopia.

However, the child is very resistant to wearing glasses! She said that none of her classmates wear glasses, and she is worried about being discussed and laughed at by her classmates.

Dr. Gui said, let’s start with Atropine Eye Drops , only for the left eye, 1 drop every night. (I remember that it was quite a detour to buy the eye drops at the time, and I had to find the manufacturer of the eye drops to buy them)

As a high myopia player, my child’s 50 degrees of myopia is actually acceptable to me, so careless me did not strictly follow the doctor’s advice to have a re-examination every 3 months, the second re-examination was already more than half a year later…

At the end of August 2022, I took the child to Dr. Gui for a re-examination on the tail of the summer vacation. Even though we insisted on using Atropine Eye Drops every day , due to zero outdoor activities, coupled with the long screen time brought by various online classes, in 8 months :

• Left eye: The degree of myopia has increased by 100 degrees, the eye axis has increased by 0.33mm ;

• Right eye: Still not myopic, but the eye axis has increased by 0.13mm .

Dr. Gui said to me very seriously – the progression rate of this eye axis is too fast , and stronger control measures are needed. Although Atropine works well for some children, the data for our child is really not ideal.

But when it comes to wearing glasses, the child still makes a face and is very resistant. So, Dr. Gui suggested that we could try “contact lenses” , such as:

• MiSight worn during the day (scientific name “Defocus Soft Lenses”)

• OK lenses worn at night

Considering the need to clean and care for OK lenses, and thinking about the extra tasks every morning and evening, I have a headache. As a “handicapped party” + “lazy party”, after discussing with the child, we chose MiSight to wear during the day .

Dr. Gui Sifeng

Distinct Health Ophthalmologist

Peer Review and Additional Input✍️

I have to say that this MiSight is really convenient. Just like daily disposable contact lenses, individually packaged, just wash your hands before wearing, at the beginning it was not skilled, it took more than ten minutes each time to wear the lenses, but later it only took a few seconds to put it on.

No one can tell, normal activities at school during the day are not affected at all, take it off before going to bed at night and throw it away, when going out, just pack a few pieces in the washbag, how many days to go out, just bring a few pieces, it doesn’t take up any space. Continue to use Atropine Eye Drops on the left eye before going to bed at night.

Interlude One: MiSight and Dry Eye Syndrome

With the lesson of delaying the re-examination last time, we came to have our eyes checked on time three months later. In addition to carefully measuring various data related to vision, the optometrist also performed a “Corneal Endothelial Cell Count” examination for us.

Dr. Gui said that wearing defocus soft lenses is convenient, but there is a possibility of causing dry eye, so it is necessary to monitor the child’s eye health status. Especially in our case, where the screen time is really too long, and the intensity of learning with eyes is high, it is important to observe.

Re-examination after 3 months of wearing lenses – the eye axis is well controlled, and the corneal endothelial cell examination results are also good.

MiSight wearing 1 week: 2022.9.17 Corneal Endothelial Cell Examination Report▼

MiSight wearing 3 months: 2022.12.10 Corneal Endothelial Cell Examination Report▼

MiSight wearing 6 months: 2023.3.25 Corneal Endothelial Cell Examination Report▼

During the re-examination after wearing the lenses for 6 months, Dr. Gui said that the data showed that the left eye had a bit of dry eye symptoms, and suggested that we start using Hyaluronic Acid Eye Drops to strengthen eye moisture care.

But because the child didn’t feel any discomfort at this time, I also always forgot and didn’t use it seriously.

Time came to April 2024 (wearing lenses for 19 months) , during that time, the child often told me that the left eye was sore and uncomfortable, more noticeable in the afternoon and evening, but it got better after a sleep, but it always recurred.

Because it was the eye that was wearing the lenses continuously, although it was not time for the regular re-examination, we still came to the ophthalmology department. Dr. Gui carefully examined the child’s eyes and said that the meibomian gland openings of both eyes were a bit blocked, and the left eye with lenses was more obvious, and suggested that we start initial dry eye treatment, including:

• Hot eye mask

• Frequent use of artificial tears

• (Can try) Meibomian gland massage

Perhaps because she was really worried about my carefree mother, Dr. Gui, like ascience popularization teacher, carefully explained to the child the pathogenesis of dry eye and how to protect the eyes to better maintain eye health.

The child listened carefully and agreed to try a meibomian gland massage.

Dr. Gui is carefully explaining dry eye to the child

Wearing a hot eye mask to rest for a while

Meibomian Gland Massage

The optometrist’s technique is professional and gentle, and the child can fully accept it

It is said that the acceptance of meibomian gland massage varies from person to person, some people (like me) don’t feel any discomfort, some people feel very uncomfortable. Fortunately, the child’s acceptance is okay, and the first meibomian gland massage of life was successfully completed.

Subsequently, we carry out 15 minutes of eye hot compress every night, with Hyaluronic Acid Eye Drops , the child’s left eye discomfort gradually eased. Subsequently, while continuing to wear MiSight, occasionally use Hyaluronic Acid Eye Drops for the eyes, and the child never told me that the eyes were uncomfortable.

“Technology and Hard Work” –

Star Interest Control Frame Glasses

Star Interest Control looks like this (note the circles on the lens)

Further Reading: Can’t wear contact lenses, but want to control myopia development well, are there other ways?

Interlude Two: Accommodation Function and Reversal Shots

With the extension of the use of Atropine Eye Drops, our regular vision examinations have added an item of “accommodation function” .

The examination in February 2025 found that the child’s binocular accommodation function was slightly weak, and at Dr. Gui’s suggestion, we started using reversal shots .

Dr. Gui Sifeng

Distinct Health Ophthalmologist

Peer Review and Additional Input✍️

July 26, 2025, ophthalmology examination report screenshot (partial)

Not a “Technology and Hard Work” method:

Indoor Lighting

Seeing this, many ophthalmologists and many responsible mothers may shake their heads…

But! Please allow me to make up for it!

Although I still haven’t arranged outdoor activities for my child, (it’s really hard to arrange, I don’t have time, and she doesn’t like to go out) , but in life, I have made some efforts –

Most of the lights in the house have been changed, all ceiling lights have been changed to 60w LED warm white light;

As long as the child studies, reads, or uses their eyes closely, nearby, an eye protection desk lamp is placed.

Just recently, our Distinct Health has released a self-developed illuminance meter, and I bought it as soon as possible and used it to test the illuminance of the child’s study desk, which easily met the standard.

With the ceiling light + 2 desk lamps on at the same time, the illuminance can even reach more than 2000LUX. For friends interested in the same illuminance meter, click here:

This desk lamp (upper right corner of the photo) is adjustable in brightness, and when the brightness reaches 1000-2000LUX range, our child finds it very comfortable.

Dr. Gui Sifeng

Distinct Health Ophthalmologist

Peer Review and Additional Input

Summary

From the beginning of standardized refraction and regular vision checks, to now using various control measures one after another, more than 4 years have passed unconsciously.

During the 8 months of starting to use Atropine alone:the left eye’s eye axis increased by 0.33mm, and the degree increased by100 degrees;

Later, it was changed to Atropine + MiSight, from August 2022 to now, during this3 years and 5 months: the left eye’s eye axis increased by0.29mm, and the degree increased by75 degrees.

Among the families Dr. Gui has接触过, ours may belong to the worst habits, “the least promising” kind, 4 years basically zero outdoor, daily high-intensity eye use ( I recently inadvertently looked at the child’s tablet usage time, several hours a day during the holiday) .

But just like teachers teaching, “teaching without discrimination”, when we such “poor students” also want to benefit from myopia control, under the professional advice of ophthalmologists, various “cheats”, relying on these “technology and hard work”, we have achieved the control effect we expected.

For dry eye, we are also paying more and more attention, using Hyaluronic Acid Eye Drops seriously every day, and not long ago, we also took advantage of the Double 11 event to buy a dry eye treatment package and had 3 IPL dry eye treatments, and the brave little sister also successfully completed it～

Further Reading: Why does your dry eye syndrome keep recurring and not getting better? Because you haven’t done this right!

Thank you very much to Dr. Gui for her understanding and acceptance of our “willful state”, and at the same time, I am even more grateful for her seriousness and responsibility.

Every time we have a re-examination, in addition to carefully explaining the changes in the data to us, she also cares very much about the child’s eye health, and every time she asks us if we are willing to try wearing glasses continuously, if we are willing to try changing to OK lenses, hoping to maintain control effects while reducing the risk of dry eye for the child.

• Glasses: She never gives up and always asks, and finally, during this re-examination, the child “relented” – willing to try wearing glasses continuously after entering junior high school, “I can accept facing new classmates in junior high school with glasses on.”

• OK Lenses: I still find the care troublesome and temporarily declined, Dr. Gui still showed understanding and acceptance, but I believe that if it really comes to a time when OK lenses are more appropriate, she will communicate with us seriously again.

Sharing our story is not to encourage everyone to follow suit and put all the pressure of control on doctors and “cheats”. Here, please allow me to issue a call from a “poor student” –

In terms of eye use habits, we are a negative example! Don’t copy the homework of poor students!

If possible, try to take your child outdoors, outdoor activities are the most cost-effective myopia control measures.

At the same time, I hope that families who for various reasons really can’t do outdoor activities, don’t give up on children’s vision control, there are still many things that can be done, no matter what is better than doing nothing.

This winter vacation, find a professional, reliable, and understanding ophthalmologist, and from now on, put myopia control on the agenda!

May the children have clear eyes and grow up healthily and happily!