{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T06:30:53Z","timestamp":1786516253118,"version":"build-2736575974"},"reference-count":138,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This systematic review examined the effects of near\u2013far accommodation-based exercise and visual training on myopia-related outcomes in children and adolescents, with the aim of informing non-pharmacological and behavioral approaches to myopia prevention and control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Myopia in children and adolescents is a major public health concern and may increase the risk of high myopia and related ocular complications. In recent years, interventions such as alternating near\u2013far fixation, accommodative facility training, visual tracking, and virtual reality\u2013based visual training have received increasing attention. However, existing studies vary substantially in intervention modalities, outcome measures, and follow-up periods, and the effectiveness of these interventions for myopia-related outcomes remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In May 2026, a comprehensive search was conducted across five electronic databases, including Embase, PubMed, Cochrane, Web of Science, and CNKI, as well as Google Scholar. According to study design, the risk of bias in randomized controlled trials was assessed using the RoB 2 tool, whereas the risk of bias in non-randomized intervention studies was evaluated using the ROBINS-I tool. This review included only experimental studies that examined the effects of near\u2013far accommodation-based exercise and visual training on myopia-related indicators in children and adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 13 articles met all inclusion criteria and were included in this systematic review. The evidence suggested that near\u2013far accommodation-based visual training or sports vision interventions may help slow axial elongation or reduce the myopic shift in spherical equivalent refraction (SER\/SE). Improvements in UCVA, KVA, and AF were also observed across multiple studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Near\u2013far accommodation-based exercise and visual training may improve certain functional vision and accommodative outcomes in children and adolescents. However, their effects on myopia prevention and control should be interpreted cautiously. Axial length and cycloplegic spherical equivalent refraction are the core outcomes for evaluating myopia progression, but current evidence for these outcomes remains limited. Therefore, no confirmatory conclusion can yet be drawn regarding consistent myopia-control effects. Future well-designed randomized controlled trials with adequate follow-up and complete outcome reporting are needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420261390075<\/jats:ext-link>\n                      , registration number: CRD420261390075.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1889393","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T05:55:32Z","timestamp":1786514132000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Exercise and visual training interventions for myopia in children and adolescents: a systematic review with a focus on near\u2013far accommodation"],"prefix":"10.3389","volume":"14","author":[{"given":"Xixi","family":"Ge","sequence":"first","affiliation":[{"name":"School of Physical Education, Shanghai University of Sport","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongxu","family":"Gao","sequence":"additional","affiliation":[{"name":"Division of Sports Science and Physical Education, Tsinghua University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Performing Arts, Rizhao Marine Engineering Vocational College","place":["Rizhao, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sijun","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Physical Education, Shanghai University of Sport","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enda","family":"Zhen","sequence":"additional","affiliation":[{"name":"Mengcun Hui Autonomous County People\u2019s Court","place":["Cangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuifeng","family":"Kong","sequence":"additional","affiliation":[{"name":"School of Physical Education, Shanghai University of Sport","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujun","family":"Cai","sequence":"additional","affiliation":[{"name":"School of Physical Education, Shanghai University of Sport","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"M30","DOI":"10.1167\/iovs.18-25957","article-title":"IMI\u2014defining and classifying myopia: a proposed set of standards for clinical and 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