VISUAL SCREEN TIME EXPOSURE AND ITS ASSOCIATION WITH REFRACTIVE ERRORS IN SCHOOL-AGED CHILDREN

Abstract

Background: The increasing use of digital devices among children has raised global concerns about its impact on ocular health. Refractive errors, particularly myopia, have been observed to rise concurrently with screen time exposure, yet data from low- and middle-income countries remain limited.

Objective: To assess the relationship between daily screen time duration and the prevalence of refractive errors among school-aged children (6–12 years) in Islamabad, Pakistan.

Methods: This cross-sectional study was conducted over eight months in selected public and private schools in Islamabad. A total of 422 children aged 6–12 years were enrolled through stratified random sampling. Data on screen time were collected using parent-administered structured questionnaires, while comprehensive ophthalmologic assessments, including cycloplegic refraction, were performed to diagnose refractive errors. Statistical analyses included independent t-tests, Pearson’s correlation, and binary logistic regression using SPSS version 26.

Results: The mean age of participants was 9.1 years (±1.7), with 50.9% male representation. Refractive errors were diagnosed in 173 children (41.0%). Prevalence of refractive errors increased with screen time: 17.0% (<2 hrs), 36.0% (2–4 hrs), 46.8% (4–6 hrs), and 68.9% (>6 hrs). Myopia was the most common refractive error (58.6%), followed by hyperopia (23.6%) and astigmatism (17.2%). Children with refractive errors had a significantly higher mean screen time (4.8 ± 1.5 hrs) compared to those without (2.6 ± 1.1 hrs, p < 0.001). Logistic regression showed children with >4 hours of screen time had 2.8 times higher odds of refractive error (95% CI: 1.9–4.2).

Conclusion: Prolonged screen time is strongly associated with an increased risk of refractive errors in children. These findings underscore the need for awareness, early screening, and lifestyle modifications to preserve pediatric visual health.