University of Oklahoma Health Sciences Center

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Author/s:

Ahnul Ha, Yun Jeong Lee, Marvin Lee, Sung Ryul Shim, Young Kook Kim

Date Added:

February 27, 2025

Journal/Publication:

JAMA

Publication Date:

February 3, 2025

URL:

Digital Screen Time and Myopia: A Systematic Review and Dose-Response Meta-Analysis

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jamanetworkopen.2024.60026

PMID (1):

39982728

Keywords

screen time

myopia

MeSH

Screen Time*

Myopia* / epidemiology

RPR Commentary

Screen appears to be associated in a dose response pattern with myopia. Perhaps another argument to use with parents though causation has not been firmly established. James W. Mold, MD, MPH

Abstract

Importance: The association of digital screen time with myopia has been documented, but the dose-response association and safe exposure threshold remain unclear.

Objective: To evaluate the dose-response association of time spent on digital screens with myopia risk.

Data sources: PubMed, EMBASE, Cochrane Library databases, CINAHL, and ClinicalTrials.gov were searched for full-length articles from peer-reviewed journals without restrictions on study design, publication date, or language from inception to November 25, 2024.

Study selection: Primary research articles investigating the association of exposure to digital screen devices (ie, smartphones, tablets, game consoles, computers, or television) with myopia-related outcomes (ie, prevalent or incident myopia and the rate of myopia progression) were identified by reviewers.

Data extraction and synthesis: Two independent reviewers extracted data using a standardized procedure in accordance with the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. A random-effects, dose-response meta-analysis (DRMA) was utilized to examine the pattern of the association of screen time with myopia.

Main outcome and measures: Increased odds of myopia per hour of daily screen time.

Results: In the linear DRMA of 45 studies with 335 524 participants (mean [SD] age, 9.3 [4.3] years), an additional hour of daily screen time was associated with higher odds of myopia (odds ratio [OR], 1.21; 95% CI, 1.13-1.30). The nonlinear DRMA of 34 studies with 314 910 participants also indicated higher odds of myopia with increasing screen time, ranging from 1 hour of daily exposure (OR, 1.05; 95% CI, 1.01-1.09) to 4 hours (OR, 1.97; 95% CI, 1.56-2.40). The dose-response curve showed myopia risk increasing significantly between 1 to 4 hours of daily screen time, and then rising more gradually after 4 hours.

Conclusions and relevance: In this systematic review and DRMA, a daily 1-hour increment in digital screen time was associated with 21% higher odds of myopia and the dose-response pattern exhibited a sigmoidal shape, indicating a potential safety threshold of less than 1 hour per day of exposure, with an increase in odds up to 4 hours. These findings can offer guidance to clinicians and researchers regarding myopia risk.

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