New York, NY – Scientists at the SUNY College of Optometry have proposed a new hypothesis regarding the global rise in myopia, or nearsightedness, suggesting the condition may be less about screen time and more about the interplay between low-light environments and sustained close-up focus. The research, slated for publication in Cell Reports on February 17, 2026, at 11:00 am Eastern Time, posits that insufficient retinal illumination during near work is a key driver of the condition.
Myopia is reaching epidemic proportions worldwide, affecting nearly 50 percent of young adults in the United States and Europe, and approaching 90 percent in parts of East Asia. While genetic predisposition plays a role, the rapid increase in prevalence over recent generations indicates significant environmental factors are at play, according to the study.
“Myopia has reached near-epidemic levels worldwide, yet we still don’t fully understand why,” said Jose-Manuel Alonso, MD, PhD, SUNY Distinguished Professor and senior author of the study. “Our findings suggest that a common underlying factor may be how much light reaches the retina during sustained near work — particularly indoors.”
The research team’s hypothesis centers on the pupil’s response to both brightness and focus distance. When outdoors in bright light, the pupil constricts to regulate the amount of light entering the eye. However, when focusing on close objects indoors – such as smartphones, tablets, or books – the pupil also constricts to sharpen the image. In dim indoor lighting, this combination significantly reduces the amount of light reaching the retina.
“In bright outdoor light, the pupil constricts to protect the eye while still allowing ample light to reach the retina,” explains Urusha Maharjan, a doctoral student at SUNY Optometry who conducted the study. “When people focus on close objects indoors, such as phones, tablets, or books, the pupil can also constrict, not because of brightness, but to sharpen the image. In dim lighting, this combination may significantly reduce retinal illumination.”
The study suggests that insufficient retinal illumination hinders robust retinal activity, contributing to the development of myopia. Conversely, exposure to bright light regulates pupil constriction based on image brightness, preventing the condition from developing. Researchers found that negative lenses, often used to correct nearsightedness, further reduce retinal illumination by inducing pupil constriction through a process called accommodation – the eye’s ability to focus on objects at varying distances.
This pupil constriction becomes more pronounced when viewing distances are shortened or excessively strong negative lenses are worn. Prolonged periods of accommodation, and the resulting constriction, exacerbate the effect, particularly in individuals already developing myopia. The research also identified disruptions in eye turning and blink efficacy as contributing factors to pupil constriction.
The proposed mechanism offers a potential unifying explanation for various approaches currently used to induce and control myopia. These include visual deprivation, negative lenses, multifocal lenses, ophthalmic atropine, contrast-reduction techniques, and increased time spent outdoors. According to the researchers, all these methods influence retinal illumination and pupil constriction.
The study suggests that effective myopia control may involve exposing the eye to safe levels of bright light while limiting accommodative pupil constriction. This could be achieved through lenses that reduce accommodation strength (multifocal or contrast-reduction lenses), medications like atropine drops that block muscles driving pupil constriction, or simply spending time outdoors focusing on distant objects. The researchers predict that any myopia control approach will be ineffective if the eye is exposed to excessive accommodation indoors under low light for extended periods.
“This is not a final answer,” Alonso emphasized. “But the study offers a testable hypothesis that reframes how visual habits, lighting, and eye focusing interact. It’s a hypothesis grounded in measurable physiology that brings together many pieces of existing evidence. More research is needed, but it gives us a new way to think about prevention and treatment.”
