Digital devices and the myopia epidemic in children: Short‐ and long‐term effects of use and strategies to manage ocular symptoms

Purpose: The prevalence of myopia is increasing around the world, stimulating interest in methods to slow its progression. The primary justification for slowing myopia progression is to reduce the risk of vision loss through sight‐threatening ocular pathologic features in later life. By 2050 over 5 billion individuals 50% of the world population will be myopic according to the estimations. Methods: Literature searches in the PubMed Cochrane Library, and clinical trial databases with no date restrictions, but limited to articles published in English, Spanish and French, were published last on May 1, 2023. The searches yielded 215 citations, 112 of which were reviewed in full text by the first author. Ten articles met the criteria for inclusion (randomized or nonrandomized comparative studies, or case series with a minimum 400 patients; evaluating awareness of increasing myopia prevalence, perceived efficacy and adoption of available strategies). Results: The 10 included studies consisted of 3 randomized clinical trials, 3 nonrandomized comparative studies, 3 case series, and 1 global survey of clinical management. 6 papers investigated the association between screen use and myopia in the context of other near work activities. The combined effect of near work showed an increased ratio for myopia development. 2 papers focused on evaluate the evidence for association between time outdoors exposure and the reduction risk of onset of myopia. Finally, 2 papers evaluated the awareness of increasing myopia and its consequences showing that each additional 1 D of myopia is associated with a 58%, 20%, 21%, and 30% increase in the risk of myopic maculopathy, open‐angle glaucoma, posterior subcapsular cataract, and retinal detachment, respectively. Conclusions: From our results, we can conclude that within our samples of children studies, increased screen use is associated with myopia development. The effect of combined near work was decreased by outdoor exposure. The risks of digital devices on myopia and the protection by outdoor exposure should become widely known. Further advocacy and collaboration with policy makers, health regulatory bodies, and industry is needed to enhance accessibility and affordability of treatment options to address the growing health burden of the myopia epidemic.