Study suggests indoor near-work in low light may contribute to myopia progression, development

Researchers at the SUNY College of Optometry have proposed a new hypothesis on the drivers of myopia, suggesting that prolonged close-up focus in low-light indoor environments — rather than screen use alone — may play a central role. The study is scheduled for publication in Cell Reports, according to a news release.¹

Myopia affects nearly 50% of young adults in the United States and Europe and close to 90% in parts of East Asia. Although genetics contribute to risk, the rapid rise in prevalence over recent generations has pointed to environmental influences. Previous research has shown that time spent outdoors appears protective, extended near work is associated with increased risk, and interventions such as atropine eye drops, multifocal lenses, and contrast-reducing optics can slow progression. The mechanisms underlying these observations have remained unclear.¹

“Myopia has reached near-epidemic levels worldwide, yet we still don’t fully understand why,” said Jose-Manuel Alonso, MD, PhD, SUNY Distinguished Professor and senior author of the study, in the release. “Our findings suggest that a common underlying factor may be how much light reaches the retina during sustained near work — particularly indoors.”

The researchers propose that pupil constriction may be a unifying factor. In bright outdoor light, the pupil constricts while still allowing substantial light to reach the retina. During near work indoors, the pupil may also constrict to sharpen images. In dim lighting, this combination could reduce retinal illumination.¹

“In bright outdoor light, the pupil constricts to protect the eye while still allowing ample light to reach the retina,” said Urusha Maharjan, a SUNY Optometry doctoral student who conducted the study, in the release. “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.”

According to the authors, prolonged reductions in retinal stimulation may affect neural pathways involved in visual processing and contribute to myopia development and progression. The hypothesis may help explain why outdoor exposure, atropine, and certain optical interventions appear to influence myopia progression.¹

“This is not a final answer,” Alonso said in the release. “It’s a 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.”

The study was conducted by Maharjan in the laboratories of Alonso at SUNY College of Optometry.

Reference

1. New research suggests myopia could be caused by how we use our eyes indoors. News release. State University of New York College of Optometry. Accessed February 19, 2026. https://www.sunyopt.edu/new-research-suggests-myopia-could-be-caused-by-how-we-use-our-eyes-indoors/