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"Also, while various theories such as increased light exposure, release of dopamine from retina, increased depth of field have been suggested to explain the protective effect of outdoor time, the mechanism remains to be elucidated"
Correlation is not causation.
That depends entirely on how the correlation is determined. For example randomized control trials can establish causal inference.
You can establish causation even if you don't know what the mechanism is. I don't know to what extent causation has been established here though, I'm not familiar enough with the research. But at minimum the intuitive idea that there is a noncausative correlation because kids with bad eyesight choose to stay inside more does not seem to stand, since this phenomenon can exist at a population level (so countries where schools start younger - and kids go outside less - have significantly higher rates of myopia).
I am familiar with the research. We don't know the reason for nearsightedness. There is no known proven causation. It is likely there are different causes for it.
Being from a sunny country lowers the chance of it (so you're less likely to be nearsighted if you're from Spain compared to Norway), even when controlled for hours spent outdoors.
There are studies that just look at outdoor time. I don’t think we know the specific mechanism but we know enough to have recommendations.
This is very interesting