Plano is a Singapore-based health technology company that was developed with the goal of saving eyesight and empowering lives in people worldwide. The company utilises thinking that is supported by scientific research and provides innovative technological solutions to help reduce the public health problems posed by excessive and inappropriate device usage and myopia (short-sightedness). Recently (2021), the company has led a global comprehensive study investigating the relationship between myopia and device use in children worldwide that was published in The Lancet Digital Health.
What was the focus of the study?
This most recent study led by Plano researchers was focused on conducting a comprehensive search of the scientific literature on the relationship between myopia and device use worldwide, to try and provide a better understanding of the effects of device use on myopia .
Myopia is a type of visual impairment where near objects appear clear, however far away objects appear blurred. It is estimated that 50 percent of the world population will be myopic by 2050 . Not only is the number of cases of myopia on the rise, but there is also a noticeable reduction in the age of myopia onset , and therefore the severity of myopia once it stabilises around early adulthood years . Associate Professor Mohamed Dirani, the Managing Director of Plano, states that with the right knowledge “we can intervene early to prevent myopia.” All of these facts are reasons why this study in particular is so vital to combat the growing problem of myopia.
The study was carried out by world experts on eye health and epidemiology from Singapore, Australia, the United Kingdom, and China. The Lancet Digital Health Journal is a peer-reviewed medical journal that publishes world-leading articles and studies in medicine. In order to evaluate the potential risk factor device use is for myopia, the authors reviewed published literature on these matters from the online databases, MEDLINE and Embase. These are both prominent library databases for biomedical and pharmacological information. More specifically their search was focused on the available research pertaining to myopia and device use in children and young adults. In the original search, the researchers found 3335 articles, 33 of which were included in the systematic review.
The study notes that a large part of the reason this type of investigation is so necessary is because of the ambiguity in previous study results. In some population-based studies, there is a link between increased device use and various changes to the eye that provide the conditions for myopia. However, some studies find no evidence linking these two factors. This inspired the team of authors to provide a large-scale systematic review of studies into the effects of device use on myopia specifically in children and young adults, with the objective of providing more clarity on the relationship. In order to better quantify and summarise the results from all the collated literature, the authors also conducted a meta-analysis. This allowed them to input the statistics from studies that were of different formats and create a field that made a comparison of the data more reliable.
What were the key findings of the study?
The study found that high levels of smart device screen time were associated with almost a 30% higher risk of myopia, and when excessive computer screen time was added, this increased to almost 80%.
In the study, the authors also found that smartphone screen time is associated with increased axial length. Axial length is the measure of the length of the eye. The longer the axial length, the more myopic a person is. This is because when the axial length becomes too long, the light that enters the eye focuses in front of the retina rather than onto the retina. The retina is the light-sensitive tissue that lines the back of the eye. With this in mind, the authors go on to note that the average screen time is 8 hours per day .
In the current world, post COVID-19 pandemic, myopia poses an even bigger threat. The authors note that the lifestyle changes that have come with the pandemic, like the work from home order and online learning activities, have a potentially detrimental impact on eye health worldwide. With the increased amount of near work, computer and device screen time, and reduced time outdoors, our eyes are suffering, and research like this is imperative.
 Joshua Foreman, Arief Tjitra Salim, Anitha Praveen, Dwight Fonseka, Daniel Shu Wei Ting, Ming Guang He, Rupert R A Bourne, Jonathan Crowston, Tien Y Wong, Mohamed Dirani. Association Between Digital Smart Device Use and Myopia: A Systematic Review and Meta-Analysis. Lancet Digital Health Journal. 2021.
 BA Holden, TR Fricke, DA Wilson et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 Through 2050. Ophthalmology 123, pages 1036-1042. 2016.
 M Dirani, YH Chan, G Gazzard et al. Prevalence of Refractive Error in Singaporean Chinese Children: The Strabismus, Amblyopia, and Refractive Error in Young Singaporean Children (STARS) Study. Invest Ophthalmol Vis Sci 51, pages 1348-1355. 2010.
 IG Morgan, AN French, RS Ashby et al. The Epidemics of Myopia: Aetiology and Prevention. Prog Retin Eye Res 62, pages 134-149. 2018.
 V Rideout. The Common Sense Census: Media Use by Kids Age Zero to Eight. San Francisco, CA: Common Sense Media. 2017.