Association between screen time and guardian-reported vision difficulty in children and adolescents: A population-based analysis

To investigate associations between screen time and guardian-reported vision difficulties among paediatric populations in the United States. Retrospective, population-based, cross-sectional study. Using data from the 2020 and 2022 National Health Interview Survey, this study included participants aged 2-17 years with complete guardian-reported data pertaining to vision status and screen time usage. We performed logistic regressions to explore associations between screen time and vision difficulties, reporting odds ratios (ORs) and 95% confidence intervals (CIs). A total of 5,112 participants (mean age: 10.1 ± 4.7 years) were included in 2020, and 6,473 participants (mean age: 9.9 ± 4.7 years) were included in 2022. In our univariable analysis, children who had a screen time of >2 hours/day had a higher odds of guardian-reported vision difficulty in 2020 (OR=1.53, 95%CI=[1.08, 2.16], p=0.017) and in 2022 (OR=1.38, 95%CI=[1.02, 1.86], p=0.038). These findings were consistent in a subgroup of female children (p=0.002 in 2020 and p=0.014 in 2022). Our multivariable analysis of 2020 data found that the odds of guardian-reported vision difficulty among children with a screen time of >2 hours/day was significantly higher in females (OR=1.73, 95%CI=[1.02, 2.93], p=0.040) and children residing in the Midwest (OR=2.41, 95%CI=[1.11, 5.20], p=0.026). No findings were significant in our adjusted analysis of 2022 data. Screen time was associated with guardian-reported vision difficulties in paediatric populations in the United States in our univariable analysis. However, this association was not consistently observed in adjusted models of 2020 data, and no associations remained significant in the multivariable analysis of 2022 data. Public health initiatives aimed at promoting healthy screen time habits and regular eye care among vulnerable groups of children and adolescents are encouraged.