Optimizing Light Exposure for Myopia Prevention and Control (LightSPAN)

Last updated: September 21, 2025
Sponsor: National University of Singapore
Overall Status: Active - Recruiting

Phase

N/A

Condition

Eye Disorders/infections

Myopia

Treatment

Digital Intervention

Light Intervention

Control Group

Clinical Study ID

NCT06631339
NUS-IRB-2023-767
  • Ages 7-10
  • All Genders
  • Accepts Healthy Volunteers

Study Summary

The goal of this clinical trial is to evaluate whether the optimization of daily exposure to light in primary school children can lead to better myopia prevention and control. The trial also aims to better understand the impact of light exposure on sleep and cognitive performance in children.

This trial has 3 arms namely, (1) a technical intervention arm, (2) a digital intervention arm, and (3) a control arm.

  1. technical intervention - which involves changing of classroom lighting in primary schools to ceiling lights that mimic the spectral composition of sunlight and fluctuates in intensity. Parents of children within that arm will have a sham smart-phone application (s-LightUP)

  2. digital intervention - which involves standard classroom lighting and giving parents an interventional smart-phone application (i-LightUP) that will be coupled with their child's light and activity sensor (wrist worn device ). The interventional app will provide individually tailored recommendation based on their children's behaviour (data feedback that is collected from the light and activity monitoring watch). The interventional app would then send reminder prompts/notifications to encourage parents help their children achieve required amounts of myopia-preventive light quantum target set per day.

  3. Standard care or control group which involves standard classroom lighting and parents having a sham smart-phone application (s-LightUP)

Participants will:

  • be randomised to receive either no intervention (control group), technical intervention (light intervention that mimics sunlight) or digital intervention (parents having an app that syncs with child's light and activity sensor which will provide feedback to parents to encourage and recommends increment of outdoor activities and hours).

  • have their myopia progression monitored every 6 monthly and cognitive assessment done once every 3 months over a year.

  • wear the light and activity sensor watches throughout the 1-year study period as much as possible (minimum 1 week per month) except for wet water activities such as swimming, diving and showering for research data collection purpose.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Subject must meet all the inclusion criteria below to participate in this study.

  1. Written Informed Consent form from parent / legal guardian and assent fromchild subject has been obtained

  2. Is between 7 to 10 years of age at start of study intervention which is 2January 2025 or 1 January 2026

  3. Studying in either Primary 2 or 3 classes of the participating school(s) inacademic year 2025 or 2026.

  4. Presenting visual acuity or best corrected visual acuity (BCVA) better or equalto LogMAR 0.2 (equivalent to Snellen 6/9 or better) in each eye

  5. Normal Intraocular pressure (not more than 21mmHg)

  6. No ocular conditions (e.g., optic nerve disease, glaucoma, retinal diseases)except for refractive error.

  7. No ocular conditions affecting the accuracy of the ophthalmic examinations

  8. In good general health with no significant systemic diseases that may affecteye health

Exclusion

Exclusion Criteria:

  • All subjects meeting any of the exclusion criteria at baseline will be excluded fromparticipation.

  1. Previous or ongoing myopia control treatment (including but not limited toorthokeratology, atropine, pirenzepine, myopia control spectacle and contactlenses, light therapy)

  2. Ongoing participation in other myopia prevention and control research trials

  3. Any systemic or neurologic diseases (e.g. cancer, epilepsy, Kawasaki disease)known to affect eye health or make the participant vulnerable to the ophthalmicexaminations (e.g., light flash)

  4. Any other conditions precluding adherence to the protocol includingunwillingness to refrain from myopia control treatment for the duration of thestudy

Study Design

Total Participants: 396
Treatment Group(s): 3
Primary Treatment: Digital Intervention
Phase:
Study Start date:
October 21, 2024
Estimated Completion Date:
January 26, 2027

Study Description

The primary objective of the study is to evaluate whether the optimization of daily exposure to light in primary school children can lead to better myopia prevention and control. To do so, we will evaluate the effectiveness, safety and feasibility of:

  1. Arm 1: technical intervention which involves spectro-temporal refinement of classroom lighting in primary schools using full spectrum light emitting diodes (LEDs) (CCT: 4000K) in addition to intermittent fluctuations in light levels. Parents of children in that arm will have access to a sham version of the LightUP mobile application to facilitate communication with the study team and questionnaire collection during the study.

  2. Arm 2: digital intervention which involves optimization of daily light exposure using an individualised behaviour-changing smart-phone application (Interventional LightUP application) coupled with child-worn light and activity sensors to provide parents with an individually tailored recommendation to adapt their children's behaviour and provide them with the required amounts of myopia-preventive light quantum/day. + standard classroom lighting

    As compared to:

  3. Arm 3: Standard care or control group which involves standard classroom lighting and no access to the interventional version of the LightUP application. Parents of children in that arm will have access to a sham version of the LightUP mobile application to facilitate communication with the study team and questionnaire collection during the study.

Our study will also lead to the following scalable and implementable outcomes:

  1. evidence-based lighting designs and policy recommendations for classrooms;

  2. a user-friendly, smart digital eyecare companion that aligns perfectly with Singapore's Smart Nation Initiative.

A secondary objective of this study is to better understand the impact of light exposure on sleep and cognitive performance in children. This will be achieved through continuous wrist actigraphy monitoring and through cognitive assessments, performed in classrooms, using tablets (one tablet/child). The assessment consists of validated, child-adapted, higher cognitive tasks testing the following constructs: impulse control, spatial working memory, content working memory, cognitive flexibility, reaction time, and processing speed.

Connect with a study center

  • Bedok Green Primary School

    Singapore, 469317
    Singapore

    Active - Recruiting

  • National University of Singapore, Yong Loo Lin School of Medicine, Department of Ophthalmology, Eye N Brain Research Lab

    Singapore, 119276
    Singapore

    Site Not Available

  • Wellington Primary School

    Singapore, 757702
    Singapore

    Active - Recruiting

  • Westwood Primary School

    Singapore, 649188
    Singapore

    Active - Recruiting

  • Bedok Green Primary School

    Singapore 1880252, 469317
    Singapore

    Active - Recruiting

  • Marymount Convent School

    Singapore 1880252, 297754
    Singapore

    Active - Recruiting

  • National University of Singapore, Yong Loo Lin School of Medicine, Department of Ophthalmology, Eye N Brain Research Lab

    Singapore 1880252, 119276
    Singapore

    Active - Recruiting

  • Wellington Primary School

    Singapore 1880252, 757702
    Singapore

    Active - Recruiting

  • Westwood Primary School

    Singapore 1880252, 649188
    Singapore

    Active - Recruiting

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