The Impact of Low-Light Indoor Near Work on Accommodative Pupil Constriction and Myopia Progression in School-Aged Children

DOI: https://doi.org/10.66715/jsccr/2026v3.i4.815 | Original Research | 2026 | Volume 3 | Issue 4 | Page 8-15

1. Ankit Sharma, B.Optom, M.Optom, PhD Pursuing, Assistant Professor, Department of Optometry, Om Sterling Global university Hisar, Email- aksharma90534@gmail.com

2. Hema, B.Optom, M.Optom, Clinical Optometrist , Department of Ophthalmology, Maharaja Agrasen Medical College (MAMC), Agroha, Hisar, Haryana, India, Email: hemasolanki237@gmail.com

3. Yukta Bakshi, Demonstrator, B.Optometry, M.Optometry, Fellowship in Paediatric Optometry and Binocular Vision Assessment, Maharishi Markandeshwar Deemed to be University, Mullana, Ambala, Email id : yuktabakshi77@gmail.com

The Impact of Low-Light Indoor Near Work on Accommodative Pupil Constriction and Myopia Pr.

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Corresponding Author:-

Yukta Bakshi,

Demonstrator,

B.Optometry, M.Optometry,

Fellowship in Paediatric Optometry and Binocular Vision Assessment,

Maharishi Markandeshwar Deemed to be University, Mullana, Ambala,

Email id : yuktabakshi77@gmail.com

Abstract

Background: Prolonged indoor near work is a primary environmental driver of the global childhood myopia epidemic. This study investigates the specific impact of low-light indoor illumination during near tasks on accommodative pupil constriction and its direct correlation with axial elongation and myopia progression in school-aged children.

Methods: A prospective, longitudinal cohort study was conducted over 12 months involving 150 school-aged children (aged 6–12 years). Participants were tracked during sustained reading tasks under two distinct environments: standard photopic illumination (500 lux) and low-light indoor illumination (50 lux). High-resolution pupillometry and autorefraction were used to measure accommodative pupil constriction and accommodative lag. Myopia progression was monitored via cycloplegic spherical equivalent refraction (SER) and optical biometry for axial length (AL) changes.

Results: Near tasks performed under low-light conditions resulted in a statistically significant reduction in accommodative pupil constriction (p < 0.001) compared to standard lighting. This atypical pupil dilation significantly increased the lag of accommodation, thereby exacerbating hyperopic retinal blur during close-up activities. At the 12-month follow-up, children frequently exposed to low-light indoor near work exhibited accelerated myopia progression, showing a mean SER shift of -0.68 \pm 0.18\ D and a significant increase in axial length (mean: 0.36 \pm 0.09 mm, contrasting sharply with the control cohort (p < 0.01).

Conclusion: Low-light indoor environments structurally impair the normal accommodative pupillary reflex, worsening retinal blur and driving axial elongation. Enhancing ambient indoor illumination during near work serves as a critical, accessible, and non-invasive therapeutic strategy to mitigate childhood myopia progression.