August 15, 2024
By Dwight Akerman, OD, MBA, FAAO, FBCLA, FIACLE
Photo Credit: Getty Images
Zong, Zhang, Qiao, Tian, and Xu (2024) conducted a meta-analysis to investigate the association between screen time exposure and myopia in children and adolescents. The objective of the study was to systematically review epidemiological evidence and quantitatively assess the summary effect estimates from existing literature. The researchers aimed to evaluate the correlation between screen time exposure and myopia using data from epidemiological studies.
In recent years, an increasing number of epidemiological studies have estimated screen time exposure through self-reported questionnaires. Several studies have shown a positive correlation between screen time exposure and myopia, while others have reported null results. Given that screen time exposure is almost ubiquitous in modern social life, researchers interpret that the relationship between screen time exposure and myopia is a significant public health issue. Previous systematic reviews have reported that the results of screen time and myopia were mixed.
The researchers conducted a comprehensive search of three online databases, including PubMed, Embase, and Web of Science, for relevant studies published before June 1, 2023. The risk of bias in the selected studies was assessed using the Newcastle Ottawa Scale (NOS) checklist. In total, 19 eligible studies were identified, comprising 14 high-quality studies and five moderate-quality studies.
The meta-analyses revealed significant findings regarding the correlation between screen time exposure and myopia. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) indicated a statistically significant association between high screen time exposure and myopia. Specifically, the ORs were 2.24 (1.47-3.42) for cross-sectional studies and 2.39 (2.07-2.76) for cohort studies, suggesting a higher likelihood of myopia with increased screen time exposure.
Furthermore, the researchers found a significant association between continuous exposure to screen time (per one hour/day increase) and myopia in cohort studies, with a pooled OR of 1.07 (1.01-1.13). Subgroup analysis by screen device type in cross-sectional studies revealed that screen time exposure from computers and televisions was associated with myopia, while smartphones showed no significant association. Specifically, screen time exposure from computers yielded the most substantial impact on myopia, as indicated by the odds ratios. The study also addressed the issue of publication bias. Although publication bias was detected, the researchers used the trim and fill method to adjust for it. Notably, the pooled results did not show significant changes after this adjustment, adding robustness to the findings.
The findings of this article support a significant association between screen time exposure and myopia in children and adolescents. The study’s results highlight the importance of considering screen time exposure, particularly from computers, as a potential risk factor for myopia. Given the increasing prevalence of myopia, especially in younger populations, the findings underscore the need for further research and public health interventions to address the impact of screen time on eye health.
Overall, the meta-analysis provides valuable insights into the relationship between screen time exposure and myopia, contributing to the existing body of evidence on this topic. The study’s comprehensive methodology, including systematic review and quantitative analysis of epidemiological data, strengthens the credibility of the findings and their potential implications for clinical practice and public health policy.
Abstract
The Association Between Screen Time Exposure and Myopia in Children and Adolescents: A Meta-Analysis
Zhiqiang Zong, Yaxin Zhang, Jianchao Qiao, Yuan Tian, Shaojun Xu
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.
Zong, Z., Zhang, Y., Qiao, J., Tian, Y., & Xu, S. (2024). The association between screen time exposure and myopia in children and adolescents: a meta-analysis. BMC Public Health, 24.
DOI: https://doi.org/10.1186/s12889-024-19113-5
