Education is a causal risk factor if an intervention that changes educational exposure changes the distribution of the corresponding potential outcome for myopia. An observed statistical association need not have that interpretation. Shared causes such as socioeconomic circumstances, parental behavior, genetic traits, or preference for indoor near work can confound education and myopia. Reverse causality is also possible: children with impaired distance vision may select more reading and indoor study, which can increase educational attainment without education causing the impairment.
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