The Impact of Digital Device Usage on Myopia Development in Adolescents: A Narrative Review of Current Evidence

Myopia, or near-sightedness, is a growing global public health concern, with its prevalence increasing significantly, particularly among adolescents. While genetic predisposition plays a role, environmental and lifestyle factors, including prolonged digital device use, have been implicated in myopia development. This narrative review synthesizes current evidence on the impact of digital screen exposure on myopia progression in adolescents, examining epidemiological trends, biological mechanisms, and preventive strategies. Excessive screen time, particularly with smartphones, tablets, and computers, is associated with increased near-work demand, accommodation lag, and reduced outdoor activity, all of which contribute to axial elongation and myopia progression. The biological mechanisms underlying myopia include disruptions in emmetropization, choroidal thinning, and scleral remodeling. Additionally, dopamine release, stimulated by outdoor light exposure, plays a crucial role in inhibiting excessive ocular growth, highlighting the protective effect of spending more time outdoors. Despite emerging evidence linking digital screen use to myopia, inconsistencies in study methodologies, reliance on self-reported screen time data, and the absence of large-scale randomized controlled trials (RCTs) limit definitive conclusions. Research gaps persist in understanding device-specific risks, the role of blue light exposure, and the interaction between screen time and outdoor activities. Behavioral interventions such as limiting screen time, optimizing viewing distances, and increasing outdoor exposure remain key strategies for myopia prevention. Future studies should focus on objective measurement tools, long-term cohort studies, and personalized interventions. Addressing these gaps is essential for developing evidence-based guidelines to mitigate the impact of digital device usage on adolescent eye health.