Associations Between Screen Exposure in Early Life and Myopia amongst Chinese Preschoolers

Abstract

This study aimed to explore the association between screen exposure in early life and preschool myopia. During the baseline survey of the Longhua Child Cohort Study (LCCS), data of 29,595 preschoolers were collected via a caregiver-reported questionnaire regarding children's socio-demographic characteristics, visual status, screen exposure and relevant parental information. Data of 26,433 preschoolers with normal eyesight or myopia were included in the analysis and cox regression modelling was employed to assess the associations. Results suggested the hypothesis that screen exposure in early life could be significantly and positively associated with preschool myopia, and in agreement with this hypothesis was the association being strengthened with the increasing daily exposure duration and total years of exposure; in the stratification analysis based on the presence of parental myopia, these associations still existed, and the strength of associations was stronger in preschoolers with myopic parents than those without. Moreover, a statistically significant association was only observed between initial screen exposure that occurred during 0-1-years old and myopia for preschoolers without myopic parents, while the significant associations were observed between initial screen exposure that occurred during 0-1, 1-2, 2-3, and after 3 years old and myopia for preschoolers who had myopic parents, with the strongest association found in the group of children initially exposed to electronic screens during 0-1 year old. Thus our findings indicated the hypothesis that screen exposure in early life might be associated with the occurrence of preschool myopia, and that the postnatal first year might be the sensitive period for the association. However, it is premature to conclude that early screen time leads to myopia with current data. Further longitudinal studies performed with cycloplegia are necessary to verify the hypothesis and shed light on the more urgent question whether early screen exposure contributes to the later myopia epidemic of school-aged children.

Keywords: early life; myopia; preschoolers; screen exposure.

Figure 1

Association between the initial age of screen exposure and myopia amongst preschoolers. ^e: Adjusted for children’s age, gender, feeding patterns, and premature birth; parental age at childbirth, education level, and monthly household income. ^f: children with parents having other eyesight disorders were not included in the analysis. ^g: This subgroup was the reference group for both children without/with parental myopia in the stratified analysis. ^a: p < 0.05; ^b: p < 0.001; ^c: p < 0.01.