What question did this study set out to answer?

To explore the relationship between myopia, eye parameters, and health behaviors in children aged 6 to 9 years.

February 13, 2026BMC Public Health0 citationsOpen Access

Association between myopia and refractive parameters with eye behaviors in childhood aged 6 ~ 9 years: a follow-up study in Beijing

LBLingling BaiBeijing Chuiyangliu Hospital MCManman ChenChinese Academy of Medical Sciences & Peking Union Medical College QLQian LiChina University of Petroleum, Beijing

Key Points

To explore the relationship between myopia, eye parameters, and health behaviors in children aged 6 to 9 years.
Conducted two cross-sectional assessments in Beijing with 921 and 1073 children respectively.
Measured refractive parameters using standard optometric equipment.
Applied multiple linear regression and logistic regression models for analyses.
Stratified data based on hyperopic reserve to assess differences in eye outcomes.
Myopia prevalence was 37.80% in girls vs. 33.69% in boys at baseline and 35.50% vs. 31.21% at follow-up.
Increased screen time correlated with myopia development (OR=1.49).
Prolonged use of electronic devices decreased spherical equivalent (β=-0.20).
Inappropriate reading/writing postures increased axial length (β=2.14).
Adequate sleep was protective against axial length increases (β=-8.90).

Abstract

The prevalence of myopia in children has become a major public health concern globally, with a notably rapid increase in China. This study aimed to investigate the association between myopia and refractive parameters, as well as eye health behaviors in childhood. We performed two cross-sectional assessments at the same school, the first involving 921 children aged 6 ~ 9 years initially, and the second 6 months later involving 1073 children. A total of 271 children participated in both surveys, providing longitudinal data on eye function measures and eye-related behaviours. Refractive parameters, including spherical equivalent (SE) and axial length (AL), were measured using standard optometric equipment. Multiple linear regression and logistic regression models were used to analyze eye parameters and myopia respectively. Furthermore, stratification was performed based on whether or not there was hyperopic reserve at baseline. In our longitudinal analysis, a higher prevalence of myopia was observed in girls compared to boys at both baseline (37.80% vs. 33.69%, respectively) and at a 6 months follow-up (35.50% vs. 31.21%, respectively). A notable correlation was found between increased screen time and myopia development, with the OR at 1.49 (95% CI: 1.00 to 2.23; P = 0.049). Notably, prolonged use of electronic devices was associated with a decrease in SE (β=-0.20, 95% CI: -0.37 to -0.02; P = 0.029), while poor reading and writing postures were linked to an increase in AL (β = 2.14, 95% CI: 0.69 to 3.59; P = 0.004). In the context of hyperopic reserve, adequate sleep was found to be protective against increases in AL (β=-8.90, 95% CI: -16.92 to -0.89, P = 0.042). Conversely, the use of fonts that are too small or otherwise inappropriate was associated with increased SE (β = 0.68, 95% CI: 0.12 to 1.24, P = 0.029). These findings underscore the importance of promoting healthy eye behaviors in early childhood and could inform the design of interventions aimed at preventing myopia in this vulnerable age group. Specifically, behavioral modifications can serve as an effective measure to preserve the eyesight of students who possess hyperopic reserve.

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