From evidence to action: Public health approaches to reducing screen time and mitigating myopia risk

Abstract

The global burden of myopia continues to expand, and the prevalence of myopia in East Asian populations is of particular concern. With the substantial increase in screen-based electronic devices, screen time has emerged as a potential risk factor. This review examined the relationship between screen viewing duration and myopia risk and public health strategies to reduce screen exposure among children. We conducted an evidence-based review of only meta-analyses investigating screen time and myopia association, searching PubMed from inception to January 20, 2025. Four of the six meta-analyses reviewed supported an association between prolonged screen use (> 2 or 3 hours/day) and increased myopia risk. However, methodological limitations include the predominance of cross-sectional study designs, self-reported screen time measurements, and the lack of cycloplegic refraction in some studies within the meta-analyses. Current public health strategies focus mainly on banning mobile phones in schools and limiting screen time. Technology-based solutions, such as anti-addiction systems, support and complement these strategies. Healthcare providers play a crucial role in assessing screen time patterns in children and providing evidence-based recommendations. Future studies should employ objective screen time measurements, conduct longitudinal analyses with cycloplegic refraction, and evaluate the effectiveness of screen time interventions in myopia prevention through randomized controlled trials. In addition, examining the combined effects of traditional near-work activities and screen time may provide more comprehensive insights into myopia risk factors.