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Background <p>Childhood myopia is a growing problem worldwide. In a primary school in Xinjiang, China, some classrooms had been installed with far-red/near-infrared (FR/NIR) lighting, while others kept conventional lights. This natural experiment let us test whether everyday exposure to FR/NIR light is linked to slower myopia progression in Uyghur children—a group often understudied despite high myopia rates.</p> Methods <p>In this one-year prospective observational cohort study, we invited all eligible Uyghur children in grades 2 and 3. Exposure groups were defined by pre-existing classroom lighting conditions (FR/NIR-enriched vs. Conventional-lit). Primary outcome was change in axial length (AL); secondary outcome was change in spherical equivalent refraction (SER, calculated as sphere + ½ cylinder). Propensity score matching (PSM) was employed to address confounding, with sensitivity analyses (ANCOVA and IPTW-ANCOVA) conducted to assess robustness.</p> Results <p>After PSM, 82 participants (41 per group) were included. AL increase was significantly smaller in the FR/NIR-enriched group (0.19 ± 0.09&#xa0;mm) than Conventional-lit group (0.34 ± 0.12&#xa0;mm), with a mean difference of –0.15&#xa0;mm (95% CI: –0.20 to –0.10; <i>P</i> &lt; 0.001). SER myopic shift was also attenuated in the FR/NIR-enriched group (–0.12 ± 0.46 D vs. –0.52 ± 0.59 D), yielding a mean difference of 0.40 D (95% CI: 0.16 to 0.64; <i>P</i> &lt; 0.001). Subgroup analyses suggested age-related differences.</p> Conclusions <p>Over one year, children in classrooms with FR/NIR-enriched lighting showed slower eye growth and less myopic shift. With careful statistical adjustment, these findings suggest that changing classroom lighting could be a simple, passive way to help control myopia at the population level.</p>

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A natural experiment in school lighting: observational evidence linking far-red light exposure to slower myopia progression in Chinese Uyghur schoolchildren

  • 期刊论文

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  • 发表日期：

    2026年5月30日

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  • Chang Liu,
  • Lei Chen,
  • Lanlan Wang,
  • Huijun Shao,
  • Yinling Sang,
  • Qiaoli Li,
  • Yangzong Suolang,
  • Wuqi Chen,
  • Dongwei Liu

摘要

Background

Childhood myopia is a growing problem worldwide. In a primary school in Xinjiang, China, some classrooms had been installed with far-red/near-infrared (FR/NIR) lighting, while others kept conventional lights. This natural experiment let us test whether everyday exposure to FR/NIR light is linked to slower myopia progression in Uyghur children—a group often understudied despite high myopia rates.

Methods

In this one-year prospective observational cohort study, we invited all eligible Uyghur children in grades 2 and 3. Exposure groups were defined by pre-existing classroom lighting conditions (FR/NIR-enriched vs. Conventional-lit). Primary outcome was change in axial length (AL); secondary outcome was change in spherical equivalent refraction (SER, calculated as sphere + ½ cylinder). Propensity score matching (PSM) was employed to address confounding, with sensitivity analyses (ANCOVA and IPTW-ANCOVA) conducted to assess robustness.

Results

After PSM, 82 participants (41 per group) were included. AL increase was significantly smaller in the FR/NIR-enriched group (0.19 ± 0.09 mm) than Conventional-lit group (0.34 ± 0.12 mm), with a mean difference of –0.15 mm (95% CI: –0.20 to –0.10; P < 0.001). SER myopic shift was also attenuated in the FR/NIR-enriched group (–0.12 ± 0.46 D vs. –0.52 ± 0.59 D), yielding a mean difference of 0.40 D (95% CI: 0.16 to 0.64; P < 0.001). Subgroup analyses suggested age-related differences.

Conclusions

Over one year, children in classrooms with FR/NIR-enriched lighting showed slower eye growth and less myopic shift. With careful statistical adjustment, these findings suggest that changing classroom lighting could be a simple, passive way to help control myopia at the population level.