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Combination Effect of Outdoor Activity and Screen Exposure on Risk of Preschool Myopia: Findings From Longhua Child Cohort Study


Huang L, Schmid KL, Yin XN, Zhang J, Wu J, Yang G, Ruan ZL, Jiang XQ, Wu CA, Chen WQ.





Front Public Health


  • Evidence regarding screen use and outdoor activity during very early childhood (i. e., from aged 1 to 3 years) and their potential combined links to the later preschool myopia is limited. 

  • This information is needed to release effective public health messages and propose intervention strategies against preschool myopia. 

  • We collected information regarding very early childhood screen use, outdoor activity and the kindergartens vision screenings of 26,611 preschoolers from Longhua Child Cohort Study by questionnaires.

  • Logistic regression models were used to examine the associations between reported outdoor activity, screen use from 1 to 3 years of age, and preschool myopia. 

  • Throughout very early childhood, from 1 to 3 years, the proportion of children exposed to screens increased (from 35.8 to 68.4%, p < 0.001), whereas the proportion of children who went outdoors ≥7 times/week (67.4-62.1%, p < 0.001) and who went outdoors for ≥60 min/time (53.3-38.0%, p < 0.001) declined. 

  • Exposure to fixed screen devices [adjusted odds ratio (AOR) = 2.66, 95% confidence interval (CI) = 2.09-3.44], mobile screen devices (AOR = 2.76, 95% CI = 2.15-3.58), and limited outdoor activity (AOR = 1.87, 95% CI = 1.42-2.51) during early childhood were associated with preschool myopia. 

  • Among children whose parents were myopic, the interactions between outdoor activity and fixed or mobile screen use on later preschool myopia were significant; the ORs and 95% CI were 3.34 (1.19-9.98) and 3.04 (1.06-9.21), respectively. 

  • Our findings suggest the possibility that the impact of screen exposure during early childhood on preschool myopia could be diminished by outdoor activity for children whose parents have myopia.