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New research · Ophthalmology
Frontiers in public health · 2d
Meta-analysisFrontiers in public health · 2026

Comparative effectiveness of outdoor and exercise interventions for myopia control in children and adolescents: a systematic review and network meta-analysis of randomized clinical trials.

Xiaoquan Weng, Yang Yang, Shuo Zhou, Lingyan Yuan
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OphthalmologyMeta-analysis

Racket sports ranked best for slowing eye elongation in myopic children.

Comparative effectiveness of outdoor and exercise interventions for myopia control in children and adolescents: a systematic review and network meta-analysis of randomized clinical trials.

Xiaoquan Weng … Lingyan Yuan
Frontiers in public health · 2026
Purpose

To compare and rank the effects of different sports and outdoor activities on myopia control in children and adolescents using network meta-analysis.

Methods

We systematically searched PubMed, Web of Science, Embase, the Cochrane Library, and major Chinese databases from database inception to Dec 31, 2025, for randomized controlled trials involving school-aged children and adolescents with myopia or at risk of myopia progression.

n = 9,084 participants
Results

eyes grew about 0.3 mm less over the study, slowing myopia progression

MD by subgroup · 95% CI
null = 0
Racket sports ranked highest for
-0.30
followed by increased outdoor time
-0.08
visual tracking exercise ranked highest
0.38
followed by racket sports
0.29
More results

For refractive outcomes, visual tracking exercise ranked highest for improving spherical equivalent (MD 0.38 D, 95% CI -0.04 to 0.80; SUCRA 83.7%), followed by racket sports (MD 0.29 D, 95% CI 0.00 to 0.59; SUCRA 77.0%).

More results

Subgroup analyses showed that increased outdoor time remained effective in children aged 8.5 years or younger and in interventions lasting more than 24 weeks.

Sensitivity analyses supported the robustness of the findings.

“
Conclusion · 1 of 2

Sports and outdoor activities may affect myopia control differently across outcomes.

Conclusion · 2 of 2

Racket sports showed the most consistent signal for slowing axial elongation, while visual tracking exercise and racket sports ranked higher for spherical equivalent.

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