This article was originally published in a sponsored newsletter.

It is not uncommon in clinical practice to be asked by parents and caregivers about what can be done in the home to help their children with their conditions. In this case, they ask if there is anything related to nutrition that can be done to prevent progression of myopia in children. This topic has been evaluated over several decades, but the role of nutritional factors is inconclusive.

Many early studies looked at the association between diet and myopia in children who were already myopic.¹ One article published in 1996 showed that, while children who developed myopia had lower intake levels of protein; fat; vitamins B₁, B₂, and C; phosphorous; iron; and cholesterol, they were not shorter or lighter and were therefore not likely to have been undernourished.¹ The study was only able to conclude that the children who had myopia had lower energy requirements than controls.

Some studies have suggested an association between low vitamin D levels and myopia.^2,3 Deficient vitamin A intake during adolescence has not been shown to have a significant association with myopic refractive error at 20 years old; however, studies are limited and further investigation is warranted to confirm these findings.⁴

Refined carbohydrates (refined starches and sugars) have been found to have a positive association with myopia in girls aged 4 to 18 years of age, but have a negative one in boys.⁵ This finding supports notions by Cordain and colleagues and Galvis and coworkers that suggested hyperinsulinism could increase elongation of the globe due to metabolism in scleral fibroblasts.^6,7

Studies have recently evaluated the therapeutic effect of dietary supplements of omega-3 polyunsaturated fatty acids on myopia development in both animal models and humans, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) on choroidal blood perfusion, and scleral hypoxia in animal models.⁷ Decreased choroidal blood perfusion occurs in near work, which is a risk factor for myopia in young adults.⁸Overall, evidence suggested that supplementation with omega-3 polyunsaturated fatty acids may be useful to prevent myopic progression.⁸ Although evidence is somewhat limited as compared to studies about other environmental and genetic factors that impact myopia onset and progression, there is nothing wrong with generally encouraging healthy nutrition to all patients. Good nutrition, rest, hydration, and time outdoors have other benefits to children, and considering them beyond a set of eyes is an excellent approach to guiding overall health.

1. Edwards MH. Do variations in normal nutrition play a role in the development of myopia. Optom Vis Sci. 1996 Oct;73:638-643.

2. Chiang SY, Weng TH, Lin CM, Lin SM. Ethnic disparity in prevalence of associated risk factors of myopia in adolescents. J Formos Med Assoc. 2020 Jan;119:134-143.

3. Mutti DO, Marks AR. Blood levels of vitamin D in teens and young adults with myopia. Optom Vis Sci. 2011 Mar;88:377-382.

4. Fletcher JN, Mackey DA, O’Sullivan TA, Oddy WH, Yazar S. Is dietary vitamin A associated with myopia from adolescence to young adulthood? Transl Vis Sci Technol. 2020 May 28;9:29.

5. Berticat C, Mamouni S, Ciais A, Villain M, Raymond M, Daien V. Probability of myopia in children with high refined carbohydrate consumption in France. BCM Ophthalmol. 2020 Aug 18;20:337.

6. Cordain L, Eaton SB, Miller JB, Lindeberg S, Jensen C. An evolutionary analysis of the aetiology and pathogenesis of juvenile onset myopia. Acta Ophthalmol Scand. 2002 Apr;80:125-135.

7. Galvis V, López-Jaramillo P, Tello A, et al. Is myopia another clinical manifestation of insulin resistance?Med Hypotheses. 2016 May;90:32-40.

8. Sravani G. Omega-3 Supplements Are Protective for Myopia. Rev Myopia Manage. 2022 Sept 1. Available at reviewofmm.com/omega-3-supplements-are-protective-for-myopia. Accessed Jan 27, 2023.

9. Pan M, Zhao F, Xie B, et al. Dietary ω-3 polyunsaturated fatty acids are protective for myopia. Proc Nat Acad Sci. 2021 Oct 21;118:e2104689118.