The Associations between Near Visual Activity and Incident Myopia in Children: A Nationwide 4-Year Follow-up Study
Po-Wen Ku, Andrew Steptoe, Yun-Ju Lai, Hsiao-Yun Hu, Dachen Chu, Yung-Feng Yen, Yung Liao, Li-Jung Chen
The study aimed to examine the prospective association between near visual activities and incident myopia in Taiwanese children 7 to 12 years old over a 4-year follow-up period.
There were 1958 children aged 7 to 12 years from the Taiwan 2009 National Health Interview Survey who were linked to the 2009 through 2013 claims data from the National Health Insurance system.
The study estimated the associations between 3 types of near visual activities in sedentary posture, namely reading (< 0.5, 0.5-0.9, ≥1.0 hours per day [h/d]), use of computer, Internet, and games (<0.5, 0.5-0.9, ≥1.0 h/d), and “cram school” attendance (<0.5, 0.5-1.9, ≥2.0 h/d), and incident myopia.
Overall, 26.8% of children had myopia at baseline, and 27.7% of those without myopia at baseline developed incident myopia between 2010 and 2013.
On average, they spent 0.68±0.86 h/d on computer/Internet use, 0.63±0.67 h/d on reading, and 2.78±3.53 h/d on cram school.
The results showed that children attending cram schools ≥2 h/d (hazard ratio, 1.31; 95% confidence interval, 1.03-1.68) had a higher risk of incident myopia. The effects of these activities remained similar in sensitivity analyses.
The study concluded that cram school attendance for ≥2 h/d may increase the risk of children’s incident myopia. This effect may be due to increased near visual activity or reduced time outdoors.