Association between digital screen time and refractive errors among school-aged children: A hospital-based observational study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Digital devices have become an integral part of children's education, communication and leisure activities. Prolonged use of smartphones, tablets, computers and other digital screens has increased substantially among school-aged children, raising concerns about ocular health and refractive abnormalities, particularly myopia. The relationship between screen exposure and refractive error remains incompletely understood because screen use frequently occurs together with other potential myopia-related behaviors such as prolonged near work and inadequate outdoor activity. Objective: To assess the association between daily digital screen time and refractive errors among school-aged children attending Mugda Medical College, Dhaka and to identify demographic, familial and behavioral factors associated with refractive abnormalities. Methods: This hospital-based observational study was conducted from July 2025 to June 2026 among 150 school-aged children attending the ophthalmology/eye-related outpatient services of Mugda Medical College. Children fulfilling the predefined eligibility criteria were recruited consecutively. Data were collected using a structured questionnaire covering demographic characteristics, family history of refractive error, average daily screen exposure, type of digital device, viewing distance, continuous viewing duration, near-work habits and outdoor activity. Visual acuity was assessed using a standardized Snellen chart. Objective and subjective refraction were performed as clinically appropriate and refractive error was classified according to spherical equivalent and cylindrical error. Myopia was defined as spherical equivalent refraction ≤−0.50 D. Associations were evaluated using the chi-square test or Fisher's exact test. Multivariable logistic regression was used to identify independent predictors of myopia. Statistical significance was set at p<0.05. Results: A total of 150 school-aged children were included in the study. The mean age of the participants was 10.8±2.3 years and 82 (54.7%) were male. Refractive error was detected in 62 (41.3%) children, with myopia being the most common refractive abnormality (30.7%), followed by hyperopia (6.7%) and astigmatism (4.0%). The mean daily digital screen exposure was 2.9±1.6 hours; 58 (38.7%) children used digital screens for <2 hours/day, 55 (36.7%) for 2-4 hours/day and 37 (24.7%) for >4 hours/day. Myopia was more frequent among children with higher screen exposure, particularly those using screens for >4 hours/day (p<0.001). Family history of myopia, outdoor activity <1 hour/day, prolonged near work and short viewing distance were also significantly associated with myopia. On multivariable logistic regression, screen time >4 hours/day (AOR 3.72, 95% CI 1.47-9.41; p=0.006), family history of myopia (AOR 2.84, 95% CI 1.28-6.30; p=0.010), outdoor activity <1 hour/day (AOR 2.68, 95% CI 1.19-6.04; p=0.017) and prolonged near work (AOR 2.31, 95% CI 1.02-5.25; p=0.045) were independently associated with myopia. Conclusion: The study suggests a substantial burden of refractive errors among school-aged children and indicates that higher daily digital screen exposure may be associated with increased odds of myopia. Preventive eye-health strategies should emphasize appropriate screen-time practices, regular breaks during near work, greater outdoor activity and periodic vision screening in school-aged children.
Institution: Mugda Medical College
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7204625612