人工智能(artificial intelligence, AI)在医学领域的广泛应用为探索眼部与全身健康的关系提供了新的机遇。文章回顾了眼科AI在心血管健康、神经系统健康、肾脏健康和衰老过程中的应用。在心血管健康方面，AI能够通过分析眼底图像预测心血管疾病风险因素和未来心血管事件，并提供了简便、有效的风险分层方法。在神经系统健康方面，眼科AI在阿尔茨海默病早期诊断和帕金森病识别方面显示出潜力，尽管对未来事件预测仍具挑战性。针对多发性硬化，眼科AI在诊断和预测残疾进程上展现了良好效果。在肾脏健康中，眼科AI技术通过分析视网膜图像可预测肾功能相关指标、直接检测肾病事件，展示了其在改善肾病筛查方式和减轻医疗负担方面的潜力。在衰老过程中，AI能够利用眼部图像预测生物年龄、视网膜年龄差和晶状体年龄等参数提供了生物衰老指标，为理解衰老与眼部健康的关联提供了新视角。

The widespread application of artificial intelligence (AI) in the medical field has provided new opportunities to explore the relationship between eye and whole body health. This article reviews the application of ophthalmic AI in cardiovascular health, neurological health and aging. In terms of cardiovascular health, AI can predict cardiovascular disease risk factors and future cardiovascular events by analyzing fundus images, and provides a simple and effective risk stratification method. In terms of neurological health, ophthalmic AI shows potential in early diagnosis of Alzheimer's disease and identification of Parkinson's disease, although the prediction of future events remains challenging. For multiple sclerosis, ophthalmic AI has shown good results in diagnosing and predicting the progression of disability. In kidney health, ophthalmic AI technology can predict kidney function-related parameters and detect kidney disease events by analyzing retinal images, demonstrating its potential in improving kidney disease screening methods and reducing medical burdens. In the aging process, AI can use eye images to predict biological age. Parameters such as retinal age gap and LensAge provide biological aging indicators, providing a new perspective for understanding the relationship between aging and eye health.

Ⅱ期人工晶状体(intraocular lens,IOL)植入常用于矫正先天性白内障摘除术后无晶状体眼状态。IOL屈光力计算是影响儿童Ⅱ期IOL植入术后视功能发育和改善的关键因素之一。现有IOL屈光力计算公式是基于成人有晶状体眼的数据研发，能准确预测成人眼IOL植入的屈光力，但是对儿童Ⅱ期IOL植入的屈光力预测准确性欠佳，主要原因包括：1)儿童II期植入术前为无晶状体眼，缺乏部分公式定义中的有晶状体眼的前房深度(是指从角膜前表面中央顶点到晶状体前表面的距离)和晶状体厚度。2)公式根据囊袋内植入IOL预测屈光力，但儿童Ⅱ期IOL睫状沟植入术在临床上应用更为广泛。当IOL植入睫状沟时有效晶状体位置发生前移，可能引起屈光预测误差。3)成人眼的发育已完成，目标屈光度多为正视或近视眼(-3.00 ~ +1.00 D)，但是儿童眼仍在发育，需针对其特性测算合适的远视目标屈光度(+0.50 ~ +12.00 D)以适应眼球发育引起的屈光变化。为使Ⅱ期IOL植入患儿达到术前预设的目标屈光度，对现有公式进行选择与优化至关重要。

Secondary intraocular lens (IOL) implantation is a common treatment for pediatric aphakia. The accurate prediction of IOL power calculation plays a pivotal role in the postoperative development and improvement of visual function for pediatric secondary IOL implantation. Current IOL power calculation formulas were developed based on data from adult phakic eyes and displayed good performance in adult population. However, the formulas showed poor performance in pediatric aphakic population due to the following reasons: 1) In these pediatric aphakic patients, the unavailability of phakic anterior chamber depth (the distance from corneal epithelium to the anterior surface of the lens) and lens thickness (LT) greatly limits the application of some IOL power calculation formulas. 2) IOL power calculation formulas predict the effective lens position on the basis of in-the-bag IOL implantation, whereas sulcus implantation is more widely used in pediatric secondary implantation. Effective lens position in capsular placement is more posterior to ciliary sulcus IOL placement. When applying the initial IOL power calculated for capsular implantation to sulcus implantation, it can lead to refractive errors. 3) Adult eyes have completed their development, with target refractions often being emmetropic or myopic (-3.00 ~ +1.00 D), while pediatric eyes are still developing, necessitating the calculation of an appropriate hyperopic (+0.50 ~ +12.00 D) target refraction to accommodate refractive changes due to ocular growth.To achieve the predetermined target refractive outcomes, the selection and optimization of IOL power calculation formulas is critically important for pediatric secondary IOL implantation.

随着移植技术逐年发展，异基因造血干细胞移植患者的生存期延长，长期并发症成为影响患者预后及生活质量的主要原因。眼移植物抗宿主病是异基因造血干细胞移植术后最常见的眼部并发症，发生率可高达50%以上。根据发病时间可分为急性及慢性眼移植物抗宿主病，临床上最常以慢性炎症及眼表组织纤维化为特点，主要表现为干眼和不同程度的角结膜炎，治疗较为棘手，可不同程度影响患者视觉质量及生活质量，严重可致盲。近年来眼移植物抗宿主病越来越受到国内外学者重视，其发病机制、临床特点、诊断及治疗相关研究逐渐深入，文章针对眼移植物抗宿主病的临床诊疗新进展进行综述。总体而言，眼移植物抗宿主病早期识别仍较为困难，早期诊断策略有待进一步探索。目前治疗对眼移植物抗宿主病的效果较为有限，或缺乏充足的循证医学证据，临床上缺乏针对不同严重程度及疾病活动度的分级诊疗策略，未来有待进一步探索新的治疗靶点及疾病活动监测指标，将有助于改善患者长期预后及生活质量。

Despite advancements in allogeneic hematopoietic stem cell transplantation techniques leading to improved overall survival rates, long-term complications have emerged as the primary contributors to poor prognosis and diminished quality of life. Ocular graft-versus-host disease (oGVHD), a prevalent complication affecting over 50% of patients post-transplantation, frequently manifests as refractory dry eye, often accompanied by keratoconjunctivitis. Patients with oGVHD routinely suffer from visual impairment and a decline in their quality of life.Currently, research into the mechanisms, clinical features, diagnosis, and treatment of oGVHD has progressively deepened. This article reviews the latest advancements in the clinical diagnosis and management of oGVHD. Notably, there is a pressing need for strategies focused on early diagnosis and treatment, as early recognition of oGVHD remains challenging. Existing treatments for oGVHD either exhibit limited efficacy or lack robust clinical evidence to support their use as the best available options.Further research is imperative to develop tiered diagnostic and treatment approaches, including the exploration of novel therapeutic targets and biomarkers for disease detection. Such endeavors hold the promise of enhancing patients' long-term prognosis and quality of life.

谷氨酸是哺乳动物中枢神经系统中的主要兴奋性神经递质，谷氨酸酶系统的持续激活会导致神经元的兴奋性毒性，进而引起神经元损伤和细胞死亡。兴奋性氨基酸转运体家族成员是一种多次跨膜蛋白，位于突触前膜、突触囊泡和神经胶质细胞膜上，也是一种高亲和力的钠钾依赖性载体，能够不断清除细胞外残留的谷氨酸，维持正常的突触内外谷氨酸水平和细胞内氧化还原稳态，对于保护细胞免受兴奋性毒性以及氧化应激损伤至关重要，兴奋性氨基酸转运体家族成员表水平达的失调与多种中枢神经系统疾病神经退行性变的发生和发展密切相关。在视网膜组织中，兴奋性氨基酸转运体家族成员广泛表达。目前大量研究表明，兴奋性氨基酸转运体家族成员广泛参与了青光眼、视网膜缺血再灌注损伤、年龄相关性黄斑变性等眼部疾病的发病，但具体机制有待进一步阐明。为此，文章综述了兴奋性氨基酸转运体家族成员的生理功能及其在相关眼科疾病发生和发展中作用的研究进展，为进一步阐明相关眼病发病的分子机制及新的防治靶点的发现提供新的视角。

SGlutamate is the primary excitatory neurotransmitter in the mammalian central nervous system. Persistent activation of the glutamatergic system can lead to excitotoxicity, resulting in neuronal damage and cell death. Members of the excitatory amino acid transporter (EAAT) family are multi-transmembrane proteins located on the presynaptic membrane, synaptic vesicles, and glial cell membranes. They function as high-affinity, sodium-potassium-dependent transporters, continuously clearing extracellular residual glutamate to maintain normal intra- and extracellular glutamate levels and intracellular redox homeostasis. This process is crucial for protecting cells from excitotoxicity and oxidative stress-induced damage. Dysregulation of EAATs is closely associated with the onset and progression of neurodegenerative diseases in the central nervous system. EAAT family members are widely expressed in retina. Numerous studies have demonstrated that these transporters are extensively involved in the pathogenesis of ocular diseases, including glaucoma, retinal ischemia-reperfusion injury, and age-related macular degeneration, although the specific mechanisms remain to be elucidated. Therefore, this article reviews the physiological functions of EAAT family members and their role in the development and progression of related ophthalmic diseases, providing new perspectives for further understanding the molecular mechanisms underlying these conditions and identifying novel therapeutic targets.

青光眼是一种以视网膜神经节细胞(retinal ganglion cell, RGC)及其轴突的进行性变性和丢失为主要特征的眼病，是导致视力丧失的最常见原因。尽管其具体的发病机制尚未完全明确，但众所周知，眼内压升高是青光眼进展的主要危险因素。目前，通过药物和手术治疗降低眼内压是控制疾病进展的主要手段。他氟前列素因其能有效长期稳定地降低眼内压，且不良反应轻微、患者依从性高、无明显全身不良反应，已成为治疗原发性开角型青光眼及眼高压症的一线治疗药物。近年来的研究表明，他氟前列素除了具有降低眼内压的效果外，还可能具有神经保护作用。文章对他氟前列素的药理作用及其在神经保护方面的潜在效益进行综述，为开发更有效的治疗青光眼药物提供理论依据和科研基础。然而，目前缺乏充分的临床研究证据支持其神经保护效应，未来研究应进一步探索这一领域，以促进针对视神经保护的药物开发和基于视神经再生的视觉功能重建。

Glaucoma is characterized by the progressive degeneration and loss of retinal ganglion cells (RGC) and their axons,making it one of the most common causes of vision loss. Although the exact underlying mechanisms remain unclear, it is well known that elevated intraocular pressure (IOP) is a major risk factor for the progression of glaucoma. Currently, the primary means of controlling glaucoma involves reducing IOP through medication and surgery. Tafluprost, due to its effective and long-term ability to lower IOP, minimal side effects, high patient compliance, and absence of significant systemic side effects, has become the first-line treatment for primary open-angle glaucoma and ocular hypertension. Recent studies suggest that tafluprost may also have neuroprotective effects beyond its IOP-lowering effects. This article aims to review the pharmacological and potential neuroprotective effects of tafluprost, providing a theoretical basis and research foundation for developing more effective drugs for glaucoma treatment. However, there is still a lack of sufficient clinical evidence to support the neuroprotective effects of tafluprost, and further investigations are required to explore in this field to furnish critical theoretical backing for the development of drugs that target optic nerve protection and facilitate vision restoration through optic nerve regeneration.

糖皮质激素(glucocorticoid, GC)由于其抗炎特性被广泛用于治疗眼部炎症，而G C诱导性青光眼(glucocorticoid-induced glaucoma, GIG) 作为一种常见并发症，其发病机制长期受到关注。文章综述了锌在GIG中的关键作用及其调控机制，揭示了锌在青光眼发病机制中的重要角色。锌作为人体中含量第二丰富的过渡金属，对蛋白质结构、酶催化和细胞信号调节至关重要。GC对锌分布的调控作用在不同组织和细胞类型中表现出复杂性，影响锌的摄取和释放，进而参与青光眼的病理过程。锌通过影响小梁网细胞外基质(extracellular matrix, ECM)的降解和重塑，以及视网膜神经节细胞的存活和轴突再生，在GIG的发病机制中发挥着复杂的作用。文章同时介绍了体内锌调控的现有途径，包括补充锌和减少锌的策略，提供了潜在的治疗途径。未来的研究应深入探索锌在青光眼中的作用机制以及与GC的相互作用，评估锌补充或螯合在青光眼治疗中的安全性和有效性，以及开发新型锌递送和螯合系统，有助于全面揭示锌在青光眼中的作用及治疗潜力，以实现更加精准的防治方案，改善患者预后。

Glucocorticoid (GC) is widely used in the treatment of ocular inflammation for its anti-inflammatory propery. However, glucocorticoid-induced glaucoma (GIG) is a common complication, and its pathogenesis has been extensively studied. This review summarizes the crucial role of zinc in GIG and its regulatory mechanisms, highlighting zinc's significant involvement in the pathogenesis of glaucoma. Zinc, the second most abundant transition metal in the human body, is essential for protein structure, enzyme catalysis, and cell signaling regulation. The effects of GC on zinc distribution vary across different tissues and cell types, affecting zinc uptake and release, which may contribute to the pathological processes of glaucoma. Zinc influences the degradation and remodeling of the trabecular meshwork extracellular matrix and the survival and axonal regeneration of retinal ganglion cells, playing complex roles in the pathogenesis of GIG. We discuss available strategies for regulating zinc in vivo, including zinc supplementation and reduction strategies, providing potential therapeutic approaches. Future research should explore the mechanisms of zinc's role in glaucoma and its interaction with glucocorticoids, evaluate the safety and efficacy of zinc supplementation or chelation in glaucoma treatment, and develop novel zinc delivery and chelation systems. These efforts will help fully elucidate the role of zinc in glaucoma and its therapeutic potential, enabling more precise prevention and treatment strategies to improve patient outcomes.

先天性白内障是严重影响婴幼儿视功能的疾病。随着白内障手术和人工晶状体植入手术技术的发展，先天性白内障患者术后多可获得高质量的视觉康复。然而，如何更好防治手术相关的不良事件和并发症、先天性白内障伴随的其他眼部发育不良疾病的治疗以及形觉剥夺性弱视的治疗，仍然是先天性白内障手术后需要重视的临床问题。

      封面展示的是双眼先天性白内障术后继发青光眼(左眼)与正常眼(右眼)的对比示意图。该并发症起病隐匿、难以预测，是先天性白内障术后二次致盲的首要原因。针对这一术后并发症，美国婴儿无晶状体眼治疗研究组 (infant aphakia treatment study, IATS)将儿童白内障术后青光眼相关不良事件(glaucoma-related adverse events,GRAEs，包括了青光眼和可疑青光眼)定义为：1)青光眼：眼压>21 mmHg(1 mmHg=0.133 kPa)，且有以下一种或以上的解剖学改变：(a)角膜直径增加；(b)双眼不对称进行性近视漂移伴角膜直径和(或)眼轴的增加；(c)视杯直径进行性增大，杯盘比增加≥0.2；(d)必须进行手术才能控制眼压。2)可疑青光眼：停用局部糖皮质激素(激素)后连续2次眼压>21 mmHg，或可通过抗青光眼药物控制眼压，但无上述任何青光眼的解剖改变。所以，如何更精准地预防该术后并发症，防止对患儿视功能造成进一步的损害，是目前关键的临床问题。

       因此，文章对先天性白内障摘除及人工晶状体植入术后继发性青光眼和可疑青光眼的发生、相关危险因素、治疗和预防的手段进行总结，以期进一步提高对先天性白内障术后高眼压和青光眼防治的认识，减少术后并发症对患儿视功能造成的进一步损害。

先天性白内障是严重影响婴幼儿视功能的疾病。随着白内障手术和人工晶状体植入手术技术的发展，先天性白内障患者术后多可获得高质量的视觉康复。然而，如何更好防治手术相关的不良事件和并发症、先天性白内障伴随的其他眼部发育不良疾病的治疗以及形觉剥夺性弱视的治疗，仍然是先天性白内障手术后需要重视的临床问题。

      封面展示的是双眼先天性白内障术后继发青光眼(左眼)与正常眼(右眼)的对比示意图。该并发症起病隐匿、难以预测，是先天性白内障术后二次致盲的首要原因。针对这一术后并发症，美国婴儿无晶状体眼治疗研究组 (infant aphakia treatment study, IATS)将儿童白内障术后青光眼相关不良事件(glaucoma-related adverse events,GRAEs，包括了青光眼和可疑青光眼)定义为：1)青光眼：眼压>21 mmHg(1 mmHg=0.133 kPa)，且有以下一种或以上的解剖学改变：(a)角膜直径增加；(b)双眼不对称进行性近视漂移伴角膜直径和(或)眼轴的增加；(c)视杯直径进行性增大，杯盘比增加≥0.2；(d)必须进行手术才能控制眼压。2)可疑青光眼：停用局部糖皮质激素(激素)后连续2次眼压>21 mmHg，或可通过抗青光眼药物控制眼压，但无上述任何青光眼的解剖改变。所以，如何更精准地预防该术后并发症，防止对患儿视功能造成进一步的损害，是目前关键的临床问题。

       因此，文章对先天性白内障摘除及人工晶状体植入术后继发性青光眼和可疑青光眼的发生、相关危险因素、治疗和预防的手段进行总结，以期进一步提高对先天性白内障术后高眼压和青光眼防治的认识，减少术后并发症对患儿视功能造成的进一步损害。

角膜屈光手术是目前屈光手术的主流术式，随着全飞秒、全激光手术方式的发展，手术变得更加安全精准，不仅角膜创伤小，术后恢复时间也进一步缩短。角膜具有屈光特性和典型的生物软组织力学特性，角膜力学特性不仅参与维持角膜形态，影响角膜手术尤其屈光手术的效果及预后，而且还与部分角膜疾病的发生和发展密切相关。近年来生物力学研究发展迅速，其在眼部疾病的诊疗中发挥着越来越重要的作用。角膜生物力学的变化与术前角膜的形态、不同手术方式的选择、术后角膜厚度的改变等多种因素相关，但手术导致的角膜自身形态改变是不可逆的，若术后角膜生物力学的变化较大，可能会引起医源性角膜扩张、继发性圆锥角膜等并发症的发生。为了规避术后角膜扩张风险和指导个性化的术式选择，了解角膜生物力学特性的影响至关重要。文章对角膜的基础结构、角膜生物力学特性、生物力学测量方法和不同术式及不同角膜瓣厚度术后生物力学变化的研究进展进行综述，为近视患者的个性化精准治疗提供理论指导。

Corneal refractive surgery is currently main stream of refractive surgery. With the development of femtosecond and laser surgery, the surgery has become safer and more accurate, resulting in less corneal trauma and a shorter postoperative recovery time. In recent years, biomechanics research has rapidly progressed, and its clinical application has gradually increased. The cornea not only possesses refractive properties but also exhibits typical biological soft tissue mechanical properties. Corneal mechanical properties not only play a role in maintaining corneal morphology but also influence the outcome and prognosis of corneal surgery, especially refractive surgery, and are closely related to the occurrence and development of some corneal diseases. Corneal refractive surgery involves cutting the cornea according to the patient's diopter, which disrupts the integrity of the cornea and inevitably affects its biomechanical stability. Changes in corneal biomechanics are associated with various factors, such as preoperative corneal morphology, the selection of different surgical methods, and postoperative changes in corneal thickness. However, the self-morphology changes caused by surgery are irreversible. If the postoperative changes in corneal biomechanics are significant, it may lead to complications such as postoperative corneal dilation and secondary keratoconus. To avoid postoperative iatrogenic corneal dilation and guide personalized surgical choice, it is crucial to understand the limits of influence of corneal biomechanical properties. This article reviews the research progress regarding corneal biomechanical properties and changes associated with corneal refractive surgery.

目的：以提升进行住院医师规范化培训(住培)的眼科医生临床诊疗思维能力为导向，建立LRC渐进协作教学体系(LRC Stepwise Collaborative Learning Model)。方法：2023年7月—2023年12月，以26名进行眼科住培的医生为试验组的研究对象，采用小讲课(Lecture)、教学查房(Rounds)及病例讨论(Case discussion)的LRC渐进协作教学体系，通过定量分析方法评估教学效果。结果：实施LRC渐进协作教学模式后，住培医生平均成绩由培训前的50.00 (40, 50)分提高至培训后的90.00 (80, 100)分，差异具有统计学意义(P＜0.001)。问卷调查满分5分，小讲课、教学查房和病例讨论三种教学形式的满意度满分比例分别为92.3%(24/26)，84.6%(22/26)、76.9%(20/26)，三种教学形式的满意评分分别为5.00 (5.00, 5.00)、5.00 (5.00, 5.00)、5.00 (4.75, 5.00)分。结论：LRC渐进协作教学体系作为住培教学新体系，得到眼科住培医生的认可，促进临床诊疗思维的整体提升，有助于岗位胜任力的培养，为未来教学模式的设计与实施提供了重要参考。

Objective: To introduce the LRC Stepwise Collaborative Learning Model, a novel teaching approach designed to improve clinical thinking skills in ophthalmology training. Methods: From July 2023 to December 2024, 26 ophthalmology residents were included in the experimental group, underwent training using LRC Stepwise Collaborative Learning Model of Lectures, Rounds and Case Discussions. Their educational outcomes were quantitatively analyzed. Results: The LRC Stepwise Collaborative Learning Model improved average resident scores from pre-training [50(40, 50) points] to post-training [90(80,100) points], with a statistical significance (P < 0.001). The questionnaire survey had a maximum score of 5 points, and the rates of full marks for the three teaching forms of lectures, rounds, and case discussions were 92.3% (24/26), 84.6% (22/26), and 76.9% (20/26), respectively. The satisfaction scores for the three teaching forms were 5.00 (5.00, 5.00), 5.00 (5.00, 5.00), and 5.00 (4.75, 5.00) points, respectively. Conclusions: The LRC Stepwise Collaborative Learning Model, as a new training system for residency education, has been recognized by ophthalmology residents. It facilitates the overall improvement of clinical thinking, contributes to competency development, and provides valuable insights for future teaching model designs.

目的：运用孟德尔随机化(Mendelian randomization,MR)方法，探索户外活动与近视之间的双向因果关系。方法：来自英国生物银行(UK Biobank)的大型队列研究数据，选择与欧洲血统人群中户外活动与近视相关的相互独立的遗传位点作为IV。户外活动的全基因组关联研究(genome-wide association study, GWAS)数据包含419 314名欧洲人群，而近视的GWAS数据则包含460 536名欧洲人群，其中37 362名近视者和423 174名对照者。通过运用逆方差加权法(inverse variance weighted,IVW)、加权中位数法(weighted median,WM)以及MR Egger法进行MR分析，将比值比作为效应度量指标，深入探讨两者间的双向因果联系。同时，通过MR多态性残差和异常值检测(MR PRESSO)方法剔除SNP异常值，利用MR Egger法以及IVW法的Cochran Q检验对各个单核苷酸多态性(SNP)之间的异质性进行了评估；并且使用MR Egger截距检验SNP的潜在多效性，通过“留一法”敏感性分析检验MR研究是否受单个SNP的影响。结果：IVW分析显示户外活动能显著降低近视的风险(OR = 0.934, 95% CI: 0.922～0.948, P < 0.01)。反向孟德尔随机化分析发现近视者参与户外活动的意愿较低(OR = 0.925, 95%CI: 0.777～1.103)但P = 0.39，未达到统计学意义。双向孟德尔随机化分析的Cochran Q检验、MR PRESSO检测以及MR Egger截距测试结果均显示所选IV间不存在显著异质性和水平多效性问题，而且，“留一法”敏感性分析证实，单个SNP对整体结果未见影响。结论：户外活动可能明显降低近视的风险。

Objective: To employ Mendelian randomization (MR) methods to explore bidirectional causal relationships between outdoor activities and myopia. Methods: Large-scale cohort study data from the UK Biobank were utilized, selecting independent genetic loci associated with outdoor activities and myopia within the European ancestry population as instrumental variables. The outdoor activities GWAS data included 419,314 individuals of European descent, while the myopia GWAS data comprised 460,536 individuals, including 37,362 myopia cases and 423,174 controls. MR analyses were conducted using inverse variance-weighted (IVW), weighted median, and MR Egger methods, employing the odds ratio as the effect measure to thoroughly investigate bidirectional causal connections. Mendelian randomization pleiotropy residual sum and outlier (MR PRESSO) detection method were employed to eliminate SNP outliers. Cochran's Q test, within MR Egger and IVW methods, was utilized to assess heterogeneity among individual single nucleotide polymorphisms (SNPs). MR Egger intercept testing assessed potential pleiotropy, and sensitivity analysis using the "leave-one-out" method examined the influence of individual SNPs on overall results. Results: IVW analysis demonstrated that outdoor activities significantly reduce the risk of myopia (OR = 0.934, 95% CI: 0.922~0.948, P < 0.01). Reverse Mendelian randomization analysis revealed a non-significant lower propensity for myopic individuals to engage in outdoor activities (OR = 0.925, 95% CI: 0.777~1.103, P = 0.39). Cochran's Q test, MR PRESSO, and MR Egger intercept tests in bidirectional Mendelian randomization analysis all indicated no significant heterogeneity or horizontal pleiotropy issues among the selected instrumental variables. Furthermore, sensitivity analysis using the "leave-one-out" method confirmed that individual SNPs did not significantly impact the overall results. Conclusion: Outdoor activities significantly reduce the risk of myopia.