Low-light close-up focus, not screens alone, may drive myopia epidemic

For decades, the blame for rising myopia has fallen squarely on screens. Children staring at phones. Teenagers hunched over tablets. Young adults working at computers for hours. The logic seemed airtight: more screen time, more nearsightedness. But researchers at SUNY College of Optometry have arrived at a different culprit—one that implicates not the device itself, but the way we use our eyes in the spaces where we use them.

Myopia has become a global crisis. Nearly half of young adults in the United States and Europe now have it. In parts of East Asia, the figure climbs to 90 percent. The speed of this rise—occurring over just a few generations—tells scientists that genetics alone cannot explain it. Something in how we live has changed. A study published in Cell Reports on February 17, 2026, proposes that the real driver is not screens per se, but prolonged close-up focus in dim indoor lighting, a combination that starves the retina of light.

Jose-Manuel Alonso, a SUNY Distinguished Professor and senior author of the study, frames the puzzle this way: myopia has reached near-epidemic levels worldwide, yet the mechanisms remain unclear. The research team, led by doctoral student Urusha Maharjan, identified a unifying principle that could explain why so many different interventions—from atropine drops to multifocal lenses to simply spending time outdoors—all seem to slow myopia progression. The answer lies in how much light actually reaches the back of the eye.

Here is the mechanism: when you focus on something close to your face in bright outdoor light, your pupil shrinks to protect the eye, but enough light still penetrates to the retina. Indoors, the situation changes. When you look at a phone, tablet, or book in dim lighting, your pupil constricts not because of brightness but because of the focusing effort itself—a process called accommodation. In low light, this double constriction—one from accommodation, one from the dim environment—can dramatically reduce the light reaching the retina. That reduced illumination, the researchers propose, is what triggers myopia to develop.

The study demonstrates that negative lenses, which people with myopia wear, reduce retinal illumination by triggering pupil constriction through accommodation. The effect intensifies when viewing distance shortens, when lenses are too strong, or when the focusing effort continues for prolonged periods. As myopia worsens, the pupil constriction becomes even more pronounced. The research also identified disruptions in how the eye turns and how blinking affects pupil control in myopic individuals.

If this mechanism holds up under further scrutiny, it could reshape how we think about prevention and treatment. Myopia control would no longer be about limiting screen time per se, but about managing the light environment and the eye's focusing demands. Bright light exposure with minimal accommodation—looking at distant objects outdoors—would prevent myopia. Multifocal lenses or contrast-reducing lenses would work by reducing accommodation strength. Atropine drops would work by blocking the muscles that constrict the pupil. All of these approaches would succeed because they increase retinal illumination or reduce the accommodation-driven pupil constriction that dims it.

Conversely, the mechanism predicts a clear path to failure: any myopia control strategy will falter if the eye remains exposed to excessive accommodation indoors under low light for extended periods. This is not a final answer, Alonso cautioned. It is a testable hypothesis grounded in measurable physiology, one that brings together scattered pieces of existing evidence. But it reframes the question entirely. The epidemic may not be about what we look at, but where and how we look at it.