Can a mobile app assist in slowing down myopia progression?

In a world where myopia rates are steadily on the rise, coupled with the pervasive integration of advanced technology into our daily lives and the continuous evolution of Artificial Intelligence (AI), the urgency to address myopia progression becomes increasingly apparent. With major tech players like Apple incorporating vision health features into their products, it comes as no surprise that app development is following suit, actively seeking innovative ways to counter the surge in myopia cases. But the question is, can a mobile app genuinely decrease the prevalence of myopia?

Professors Raymond Najjar and Manuel Spitschan firmly believe it can. They've launched LightSPAN, an innovative project initiated by TUMCREATE, a multidisciplinary research platform affiliated with the Technical University of Munich (TUM) at the Singapore Campus for Research Excellence and Technological Enterprise (CREATE). This pioneering research initiative aims to evaluate the effectiveness of optimising light exposure to reduce myopia prevalence in school-going children. The project introduces the smartphone application "LightUP," utilising individual behaviour to empower parents in ensuring their children receive optimal light at the right time to prevent myopia.

It is well known that time spent outdoors is linked to lower overall myopia, slowing myopic refraction by around a third [1] [2] [3]. However, for some patients/parents, consistently spending more time outdoors is not always a viable option. A prime (albeit extreme) example of this is the recent COVID-19 pandemic and subsequent lockdowns that prevented millions of children from playing outdoors.

Research has shown that Children raised in lockdown were three times more likely to be myopic than children in prior years, with average myopic shifts of around 0.3 diopters for 6–8-year-olds over a period of just one year [4] [5].

How does the app collect data?

The app employs an innovative wearable light sensor to gather data, measuring both visible and ultraviolet (UV) light exposure. Through the LightUP mobile app, users receive personalised feedback featuring visualizations of their daily light exposure and long-term trends. The app sends daily notifications to encourage users to adjust their behaviour for improved circadian rhythms, alertness, mood, and cognition. Furthermore, it offers seamless access, transfer, and tracking of light exposure details, along with timely nudges for additional exposure as needed. This functionality allows parents to effectively monitor and optimize their children's light exposure. Additionally, LightSPAN aims to assess and establish evidence-based lighting designs and policy recommendations for myopia-safe classroom lighting.

Assistant Professor Raymond Najjar, from the Department of Ophthalmology at NUS Medicine and co-principal Investigator of the LightSPAN project, said, “Children today are experiencing insufficient outdoor and natural sunlight exposure, a concerning trend that is contributing to the alarming increase in childhood myopia. The younger the age of myopia onset, the higher the risk of myopia and associated sight-threatening conditions during adulthood. We need to stop or at least delay the onset of myopia in children.

He continued: Recognising the pivotal role that outdoor exposure and natural sunlight play in reducing myopia risk, the LightSPAN project aims to introduce innovative, evidence-based strategies for myopia prevention. Through wearable light sensors, coupled with the LightUP mobile app, our initiative will empower parents to monitor their children's light exposure and support them in cultivating healthier daily light exposure habits to safeguard against myopia.”

We'd also like to point out that one major review of data conducted by City University in London suggested that exposure to daylight was more protective against the onset of myopia than in reducing the progression of existing myopia.

However, it is also important to remember the importance of outdoor time and physical activity in improving and maintaining a child's physical and mental wellbeing.

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