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Meta-Analysis
. 2024 Jun 18;24(1):1625.
doi: 10.1186/s12889-024-19113-5.

The association between screen time exposure and myopia in children and adolescents: a meta-analysis

Zhiqiang Zong  1 , Yaxin Zhang  2 , Jianchao Qiao  1 , Yuan Tian  3 , Shaojun Xu  4   5
Affiliations
Meta-Analysis

The association between screen time exposure and myopia in children and adolescents: a meta-analysis

Zhiqiang Zong et al. BMC Public Health. .

Abstract

Objective: This study aimed to systematically review epidemiological evidence on associations between screen time exposure and myopia in children and adolescents, and to quantitatively evaluate summary effect estimates from existing literature.

Method: There were three online databases including PubMed, Embase, and Web of Science, for epidemiological studies on screen time exposure and myopia published before June 1, 2023. The risk of bias was assessed by the Newcastle Ottawa Scale (NOS) checklist. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the correlation between screen time exposure and myopia using random or fixed-effect models by exposure type (categorical/continuous). We also performed subgroup analysis by screen device type, study quality, geographic region, and research period.

Results: We searched 7,571 records from three databases and identified 19 eligible studies, including 14 high-quality studies and 5 moderate-quality studies. Meta-analyses suggested that there was a statistically significant correlation between screen time (high vs. low) and myopia. The pooled ORs with 95%CIs were respectively 2.24 (1.47-3.42) for cross-sectional studies, and 2.39 (2.07-2.76) for cohort studies. We also found a significant association between continuous exposure to screen time (per 1 h/d increase) and myopia in cohort studies. The pooled ORs with 95%CIs were 1.07 (1.01-1.13). In subgroup analysis stratified by screen device type in cross-sectional studies, screen time exposures from computers (categorical: OR = 8.19, 95%CI: 4.78-14.04; continuous: OR = 1.22, 95%CI: 1.10-1.35) and televisions (categorical: OR = 1.46, 95%CI: 1.02-2.10) were associated with myopia, while smartphones were not. Although publication bias was detected, the pooled results did not show significant changes after adjustment using the trim and fill method.

Conclusion: Our findings support that screen time exposure was significantly associated with myopia in children and adolescents. Notably, screen time exposure from computers may have the most significant impact on myopia.

Keywords: Children; Meta-analysis; Myopia; Public health; Screen time.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The flowchart of literature search
Fig. 2
Fig. 2
Forest plot for the association between screen time exposure and risk of myopia in children and adolescents. (A) screen time (high vs. low) and myopia in cross-sectional studies; (B) screen time (high vs. low) and myopia in cohort studies; (C) screen time (per 1 h/d increase) and myopia in cross-sectional studies; (D) screen time (per 1 h/d increase) and myopia in cohort studies
Fig. 3
Fig. 3
Funnel plots show the risk of publication bias in the meta-analysis. (A) screen time (high vs. low) and myopia in cross-sectional studies; (B) screen time (per 1 h/d increase) and myopia in cross-sectional studies
Fig. 4
Fig. 4
Sensitivity analysis using leave-one-out method for the association between screen time exposure and myopia. (A) screen time (high vs. low) and myopia in cross-sectional studies; (B) screen time (per 1 h/d increase) and myopia in cross-sectional studies
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