The association between digital screen time and myopia: A systematic review

Abstract

Purpose Digital screen time has been cited as a potential modifiable environmental risk factor that can increase myopia risk. However, associations between screen time and myopia have not been consistently reported. Although myopia prevalence increased before the massive use of digital devices in some countries, with the rise being influenced by education, there may be an added recent effect of screen time. The aim of this systematic review is to determine the association between screen time and the risk of developing (1) prevalent or incident myopia, or (2) the risk of myopia progression in children. Published manuscripts were identified in PubMed, ScienceDirect and the Cochrane Library, and citation lists were reviewed. Recent findings Fifteen studies were included (nine cross‐sectional and six cohort studies) with a total of 49 789 children aged between 3 and 19 years old. Seven studies found an association between screen time and myopia. The results showed mixed evidence with the more recent studies exposing a trend of association between hours spent by children using screens and myopia. Meta‐analysis using a random‐effects model was performed in five studies (n = 20 889) that reported odds ratio (OR). The I2 statistics was used to assess heterogeneity. A pooled OR of 1.02 (95% CI: 0.96–1.08; p = 0.48) suggests that screen time is not associated with prevalent and incident myopia in this group of five studies. Summary The results for screen time and myopia are mixed. Further studies with objective screen time measurements are necessary to assess evidence of an association between screen time and myopia.

The Relationship Between Screen and Outdoor Time With Rates of Myopia in Spanish Children

“…Other researchers have related a higher risk of developing myopia with shorter distances for reading (<20 cm) and longer and continuous periods (>45 min), instead of joining to the total time in near activities (17). In this sense, a recent study has concluded that results are mixed and that more studies are needed to evaluate the association between screen time and myopia (36).…”

Digital screen time during COVID-19 pandemic: A public health concern

“…Multiple studies have shown adverse ophthalmological impacts associated with screen time. A meta-analytic review of 15 studies found a pooled odds ratio (OR) of myopia was 1.02 (95% confidence interval [CI]: 0.96 -1.08) in a sample of 49789 children (Lanca & Saw, 2020). A major proportion of evidence-based reviews report higher risks of noncommunicable diseases associated with screen time.…”

“…Nonetheless, people staying at home or closed places spend higher hours on watching television or using digital media for entertainment purposes (AACAP, 2020;Király et al, 2020;UNICEF, 2020). Previous research shows screen time is associated with a wide range of noncommunicable diseases among the vulnerable individuals (Janssen et al, 2020;Kuss & Griffiths, 2012;Lanca & Saw, 2020;Wang, Li, & Fan, 2019). Recent empirical studies suggest a rapid increase of digital screen time in different populations during the COVID-19 pandemic (Carroll et al, 2020;Górnicka, Drywień, Zielinska, & Hamułka, 2020;Hu, Lin, Chiwanda Kaminga, & Xu, 2020;Keel et al, 2020).…”

Children's Health in the Digital Age

“…In a systematic review article on the association between digital screen time and myopia, the authors conclude that the hours spent on digital screen time in children and adolescents and odds of myopia "are mixed" [29], and that the impact of screen time on myopia has to be further evaluated using objective screen time measures. Myopia prevalence appears to have increased primarily with increasing education in urban Asia a few decades ago and not just recently alongside with screen time [29]. There is currently no clear knowledge by how many hours per day exactly screen time in children has increased in Asia over the years, but publically available statistics showing that internet use has grown by a factor of 30 on the average in Asia over the last 20 years of the critical reference period [30] suggest that children's screen times are likely to have increased just as dramatically in the last 20 years.…”

“…Epidemiologic studies have shown that children who spent more screen time statistically consume fewer fruits and vegetables, and more energy snacks, soft drinks, or fast food, and therefore receive a higher percentage of their energy from fats and a higher total energy intake [36]. Results of a recent survey from the USA revealing the link between the severity of obesity and the number of screen time hours per day in children treated for obesity in different hospitals across the country [29].…”