Gender, Screen Time, and Caregiver Myopia Linked With Premyopia in Children

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Cute 7 year old sitting on sofa at home, concentrating on device, playing game, mobile app, learning, education
Preventative strategy exposure and higher education levels of caregivers served as protective factors against premyopia risk.

Premyopia is associated with male gender, caregiver myopia, and screen time of at least 1 hour per day during weekdays, according to a study published in Ophthalmology.

Researchers conducted a population-based, cross-sectional analysis of 21,761 children (mean age 5.15±0.37 years, 52.1% boys) from August 2014 to December 2020. They performed cycloplegic refraction and administered a survey to caregivers to obtain information on the child’s medical history, lifestyle, and near-work habits.

Investigators recorded a mean spherical equivalent (SE) refractive error of 0.57±1.09 D among the cohort. Overall 10.7% of children were myopic (0.3% high myopia vs 10.4% low myopia), 52% were premyopic, and 37.3% were hyperopic. 

They determined that male gender (OR: 1.25; 95% CI, 1.18-1.32), caregiver myopia (OR: 1.46; 95% CI, 1.37-1.56), and spending at least 1 hour per weekday on screen-based devices (OR: 1.10; 95% CI, 1.04-1.17) were associated with premyopia (P <.001 for all). A longer duration (up to 2 years) of preventative strategy exposure (OR: 0.59) and a college level education or higher achieved by the caregiver (OR: 0.91) protected against premyopia. Increased time spent outdoors was also associated with a protective effect against premyopia, but failed to achieve statistical significance.

“Our findings may support additional targeted efforts to identify premyopic preschoolers in the regions with myopia epidemic and to encourage parents to take these children to eye care professionals for early myopia intervention and close follow-up,” according to the investigators.

Limitations of the study included use of 1% tropicamide rather than 1% cyclopentolate for cycloplegic autorefraction and possible self-reporting bias.


Wang C-Y, Hsu N-W, Yang Y-C, Chen Y-L, Shyong M-P, Tsai D-C. Premyopia at preschool age: population-based evidence of prevalence and risk factors from a serial survey in Taiwan. Ophthalmol. Published online March 21, 2022. doi:10.1016/j.ophtha.2022.03.017