Is Increased Screen Time Associated with a Higher Prevalence of Myopia in Elementary-aged Children Globally?

Background: The onset of myopia in children has emerged as a significant public health concern, especially with increased screen time and reduced outdoor activity following the COVID-19 pandemic. The global prevalence of myopia is expected to rise significantly, with children being particularly vulnerable. Various studies have explored how screen time, near-work activities, and outdoor exposure influence the increasing prevalence of myopia in pediatric populations worldwide. Hypothesis: This paper aims to evaluate whether increased screen time, especially following the COVID-19 pandemic, is associated with a higher prevalence of myopia in young children, providing a more robust understanding of this relationship across studies in different countries. Methods: Specific terms and limitations were applied to PubMed and Embase searches. Search strings included “myopia,” “screen time,” “school-aged,” “elementary school,” and “prevalence,” limited to the last 20 years. Of 707 publications screened, 23 were included. Six reviewers independently assessed relevance based on age range, outcomes, and pandemic timing. Results: Most studies indicated a positive correlation between increased screen time and myopia prevalence. Several studies showed a rise in myopia during the pandemic, linked to reduced outdoor time. Some studies found no significant association. Data varied in screen time definitions, SER reporting, and methodology. Many studies were limited by recall bias, sample size, or lack of standard refraction methods. Conclusions: Myopia prevalence in children appears to rise with increased screen time and reduced outdoor exposure. Further research and public health guidelines are needed to mitigate risk and promote protective factors like outdoor activity and early screening.