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Open AccessArticle

Association between Time Spent on Smart Devices and Change in Refractive Error: A 1-Year Prospective Observational Study among Hong Kong Children and Adolescents

1
Centre for Myopia Research, School of Optometry, Hong Kong Polytechnic University, Hong Kong, China
2
Department of Health and Physical Education, Education University of Hong Kong, Hong Kong, China
3
School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
4
Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China
5
School of Medical and Health Sciences, Tung Wah College, Hong Kong, China
6
School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW 2308, Australia
*
Author to whom correspondence should be addressed.
Authors with equal contribution.
Int. J. Environ. Res. Public Health 2020, 17(23), 8923; https://doi.org/10.3390/ijerph17238923
Received: 29 October 2020 / Revised: 13 November 2020 / Accepted: 28 November 2020 / Published: 30 November 2020
(This article belongs to the Special Issue Child and Adolescent Health Care)
This study examined the association between smart device usage and the 1-year change in refractive error among a representative sample of Hong Kong children and adolescents aged 8–14 years. A total of 1597 participants (49.9% male, mean age 10.9, SD 2.0) who completed both baseline (2017–2018) and 1-year follow-up (2018–2019) eye examinations were included in the present study. The non-cycloplegic auto-refractive error was measured and the average spherical equivalent refraction (SER) was analyzed. The participants also self-reported their smart device usage at baseline. Multivariate regression adjusted for age, sex, baseline SER, parents’ short-sightedness, BMI, time spent on moderate-to-vigorous physical activity (MVPA), and caregiver-reported socio-economic status showed that, compared with the reference group (<2 h per day on both smartphone and tablet usages), those who spent ≥2 h per day using a smartphone and <2 h per day using a tablet had a significantly negative shift in refractive error (1-year change in SER −0.25 vs. −0.09 D, p = 0.01) for the right eye, while the level of significance was marginal (1-year change −0.28 vs. −0.15 D, p = 0.055) for the left eye. To conclude, our data suggested spending at most 2 h per day on both smartphones and tablets. View Full-Text
Keywords: handheld device; myopia; prospective; smartphone; tablet; teenage handheld device; myopia; prospective; smartphone; tablet; teenage
MDPI and ACS Style

Do, C.-w.; Chan, L.Y.L.; Tse, A.C.Y.; Cheung, T.; So, B.C.L.; Tang, W.C.; Yu, W.Y.; Chu, G.C.H.; Szeto, G.P.Y.; Lee, R.L.T.; Lee, P.H. Association between Time Spent on Smart Devices and Change in Refractive Error: A 1-Year Prospective Observational Study among Hong Kong Children and Adolescents. Int. J. Environ. Res. Public Health 2020, 17, 8923.

AMA Style

Do C-w, Chan LYL, Tse ACY, Cheung T, So BCL, Tang WC, Yu WY, Chu GCH, Szeto GPY, Lee RLT, Lee PH. Association between Time Spent on Smart Devices and Change in Refractive Error: A 1-Year Prospective Observational Study among Hong Kong Children and Adolescents. International Journal of Environmental Research and Public Health. 2020; 17(23):8923.

Chicago/Turabian Style

Do, Chi-wai; Chan, Lily Y.L.; Tse, Andy C.Y.; Cheung, Teris; So, Billy C.L.; Tang, Wing C.; Yu, W. Y.; Chu, Geoffrey C.H.; Szeto, Grace P.Y.; Lee, Regina L.T.; Lee, Paul H. 2020. "Association between Time Spent on Smart Devices and Change in Refractive Error: A 1-Year Prospective Observational Study among Hong Kong Children and Adolescents" Int. J. Environ. Res. Public Health 17, no. 23: 8923.

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