Abstract
This study examined the association between smart device usage and the 1-year change in refractive error among a representative sample of Hong Kong children and adolescents aged 8–14 years. A total of 1597 participants (49.9% male, mean age 10.9, SD 2.0) who completed both baseline (2017–2018) and 1-year follow-up (2018–2019) eye examinations were included in the present study. The non-cycloplegic auto-refractive error was measured and the average spherical equivalent refraction (SER) was analyzed. The participants also self-reported their smart device usage at baseline. Multivariate regression adjusted for age, sex, baseline SER, parents’ short-sightedness, BMI, time spent on moderate-to-vigorous physical activity (MVPA), and caregiver-reported socio-economic status showed that, compared with the reference group (<2 h per day on both smartphone and tablet usages), those who spent ≥2 h per day using a smartphone and <2 h per day using a tablet had a significantly negative shift in refractive error (1-year change in SER −0.25 vs. −0.09 D, p = 0.01) for the right eye, while the level of significance was marginal (1-year change −0.28 vs. −0.15 D, p = 0.055) for the left eye. To conclude, our data suggested spending at most 2 h per day on both smartphones and tablets.
Highlights
Uncorrected refractive error is the leading cause of visual impairment worldwide, according to reports by the World Health Organization [1]
We found that smartphone use in young children was associated with a negative shift in refractive error
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Summary
Uncorrected refractive error is the leading cause of visual impairment worldwide, according to reports by the World Health Organization [1]. High demands in near work, close working distance, and lack of outdoor activities are known risk factors for myopia development and progression [15,16,17]. This vulnerability to environmental stress necessitates further attention in exploring the consequences of time spent on smart devices, such as smartphones and tablets, for school-aged children’s learning and overall developmental health. We examined the association between smart device usage habits of primary and secondary school-aged children and their 1-year changes in refractive error
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