The relationship between green space and myopia in children and adolescents: a systematic review and meta-analysis

Objective: To investigate the effect of green space exposure on the risk of myopia in children and adolescents. Methods: Studies on the relationship between green space and myopia in children and adolescents published before October 1, 2024, were retrieved from five electronic databases: web of Science Core Collection, PubMed, EBSCOhost, ScienceDirect and Cochrane Library. A systematic review was conducted to summarize the relevant articles, followed by a meta-analysis. Results: = 0.053). Conclusion: Increased exposure to green spaces has a beneficial effect on reducing the risk of myopia in children and adolescents. For every 0.1 increase in the NDVI, the prevalence of myopia decreases. Furthermore, the prevention and control of myopia are more effective within school boundaries and in the surrounding 500-meter buffer zone. Therefore, it is recommended that schools and relevant government authorities focus on enhancing vegetation coverage within school grounds and around areas where students frequently engage in activities, thereby providing stronger environmental support for myopia prevention in children and adolescents. However, potential publication bias cannot be excluded given the limited number of included studies; therefore, the pooled estimates should be interpreted with caution. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251153654, PROSPERO: CRD420251153654.