Part of our myopia control for children in Singapore at The Cathay and Jelita Mall.

Screen Time, Outdoor Time and Childhood Myopia: What Parents Should Know

Originally published: 05 July 2021
Last reviewed and updated: 30 September 2026

Phones, tablets and computers are now part of everyday life for most children. Between schoolwork, entertainment and communication, many parents understandably wonder:

Is too much screen time making my child's myopia worse?

The relationship is more complicated than simply saying that screens cause short-sightedness.

Research has found an association between greater digital screen exposure and myopia in children. However, screens are also a form of near work, alongside activities such as reading, writing and drawing. Children who spend more time on devices may also spend less time outdoors, which is another important part of the myopia picture.

For parents, the practical message is not that children must avoid screens completely. Instead, it is useful to look at the child's overall visual environment: how long they spend doing continuous near work, how closely they hold devices or books, whether they take regular visual breaks, and how much time they spend outdoors.

These lifestyle habits are especially relevant in Singapore, where childhood myopia is common.

What is childhood myopia?

Myopia, or short-sightedness, is a condition in which distant objects appear blurred while nearer objects can usually be seen more clearly.

In many children with myopia, the eye grows longer than expected from front to back. This is known as axial elongation. As the eye becomes longer, the child's myopia may increase.

A child's spectacle prescription can therefore become progressively stronger as they grow.

If your child has already been diagnosed with myopia, you can learn more about myopia control for children in Singapore and the options available to help slow progression.

Does screen time cause myopia?

Research increasingly shows an association between greater digital screen use and myopia, but association does not necessarily mean that screens alone directly cause myopia.

A large 2025 systematic review and meta-analysis published in JAMA Network Open examined 45 studies involving more than 335,000 participants. Greater daily digital screen exposure was associated with higher odds of myopia.

However, the International Myopia Institute has highlighted an important distinction: it is still unclear whether digital screens themselves present a greater myopia risk than other forms of prolonged near work.

Children were developing myopia long before smartphones and tablets became common.

Reading a book at very close distance for a prolonged period and spending a long time using a tablet can both involve sustained near focusing. It may therefore be more useful to think about near-work behaviour as a whole, rather than treating screens as the only concern.

What counts as near work?

Near work includes activities performed at close viewing distances, such as:

• using smartphones and tablets;
• working on a computer;
• reading books;
• writing and homework;
• drawing and colouring;
• handheld gaming; and
• other detailed activities performed at close range.

These activities are an unavoidable and often valuable part of childhood. The objective is therefore not to eliminate near work, but to avoid unnecessarily long periods of continuous close focusing.

Why does viewing distance matter?

How a child uses a device may matter as much as the device itself.

The International Myopia Institute has reported associations between myopia and very close reading distances, particularly distances of less than approximately 20 cm, as well as long periods of uninterrupted near work.

A child holding a smartphone very close to their face for an extended period is therefore quite different from a child occasionally watching something on a screen positioned farther away.

Encourage children to maintain a comfortable working distance rather than gradually bringing books or devices closer and closer to their eyes.

Should children take breaks from screens and homework?

Yes. Regular breaks are a sensible way to interrupt prolonged near focusing.

Singapore National Eye Centre recommends frequent eye breaks during near activities and describes the commonly used 20-20-20 approach: after approximately 20 minutes of near work, spend about 20 seconds looking at something around 20 feet away.

The exact numbers are less important than developing the habit of regularly looking away from close work and changing viewing distance.

Children can also use breaks as an opportunity to stand up, move around and, where practical, spend some time outside.

Why is outdoor time important for children's eyes?

Spending more time outdoors is one of the most consistently supported lifestyle measures associated with a lower risk of developing myopia.

Singapore's Health Promotion Board recommends that children spend at least two hours outdoors each day. Singapore National Eye Centre also encourages outdoor activities as part of good eye-care habits.

Research has repeatedly found that children who spend more time outdoors have a lower risk of developing myopia. A 2024 meta-analysis involving nearly 13,000 children and adolescents found greater outdoor exposure was associated with a reduced risk of myopia onset.

Why outdoor time helps is still being investigated. Possible explanations include the much higher light levels found outdoors and biological responses within the eye that may influence eye growth.

Does outdoor time stop myopia from progressing once a child is already short-sighted?

This requires an important distinction.

The evidence supporting outdoor time for reducing the likelihood of developing myopia is stronger than the evidence that outdoor time alone can substantially slow progression once a child is already myopic.

Some research has found benefits relating to progression, while other analyses have found that the effect is much clearer for preventing or delaying myopia onset.

For this reason, outdoor activity is a valuable healthy habit, but it should not be presented as a replacement for clinically established myopia-control treatments in a child whose myopia is already progressing.

Children who are already myopic should have their progression assessed and monitored appropriately.

Does my child need to stop using digital devices?

Usually, that is neither practical nor necessary.

Digital devices are now important tools for education, communication and entertainment. Rather than focusing only on eliminating screen time, parents can encourage healthier patterns of use.

Useful habits include:

• breaking up prolonged periods of screen use and homework;
• encouraging children to look into the distance regularly;
• avoiding very close viewing distances;
• using devices in a well-lit environment;
• encouraging daily outdoor activities;
• avoiding unnecessary recreational screen use when it replaces outdoor play; and
• paying attention to symptoms such as squinting, blurred distance vision or headaches.

What about blue light from screens?

Blue light is often discussed when parents ask about children's screen use, but it should not be confused with the mechanisms involved in childhood myopia.

Current evidence does not support treating blue-light-filtering spectacle lenses as a myopia-control treatment.

The more relevant considerations for childhood myopia are factors such as near-work behaviour, viewing distance, time spent outdoors, age of myopia onset, family history and the child's actual pattern of eye growth and prescription change.

Screens can also contribute to symptoms of digital eye strain because children may concentrate for long periods and blink less frequently. Eye strain and myopia, however, are not the same condition.

How can I tell if my child may be becoming short-sighted?

Children do not always realise that their distance vision has become blurred because the change can happen gradually.

Parents may notice behaviours such as:

• squinting when looking at objects in the distance;
• moving closer to the television;
• difficulty seeing the board at school;
• bringing objects unusually close;
• complaining of blurred distance vision; or
• a previously diagnosed myopic prescription becoming stronger.

If these changes occur, an eye examination can determine whether myopia is present and whether the child's prescription has changed.

What if my child already has myopia?

If a child's myopia is increasing, lifestyle habits remain important, but the next step should be to determine how quickly the myopia is progressing.

At EMME Visioncare, childhood myopia assessment considers factors such as the child's age, current and previous prescriptions, age of onset, family history, visual habits and eye health.

We also measure axial length for children undergoing myopia assessment. Tracking changes in the length of the eye provides additional information about eye growth that cannot be obtained from spectacle prescription alone.

Read our guide to axial length and why it matters in childhood myopia.

Can lifestyle habits replace myopia-control treatment?

Healthy visual habits and outdoor time should be encouraged for all children, but they are not substitutes for evidence-based myopia-control treatment when treatment is clinically appropriate.

Depending on the individual child, myopia-control options may include:

• orthokeratology (Ortho-K);
• MiSight 1 Day myopia-control contact lenses;
• HOYA MiYOSMART and other specialised myopia-control spectacle lenses; and
• atropine eye drops prescribed and managed medically where appropriate.

Each option has different practical considerations, and no single treatment is universally best for every child.

For a detailed overview, read our guide to myopia-control treatments and how the main options compare.

A practical approach for parents

Parents do not need to make children afraid of screens or constantly count every minute spent reading.

A more useful approach is to encourage balance:

• regular outdoor activity;
• reasonable viewing distances;
• frequent breaks during prolonged near work;
• good lighting;
• appropriate screen habits; and
• regular eye examinations when indicated.

If your child is already short-sighted, monitor their progression rather than relying on lifestyle changes alone.

When should my child have a myopia assessment?

Consider arranging an assessment if your child has recently developed myopia, their spectacle prescription is becoming stronger, there is a strong family history of myopia, or you are concerned about how quickly their vision is changing.

A myopia assessment can establish a baseline and help determine whether monitoring alone or an active myopia-control strategy should be considered.

Learn more about myopia control at EMME Visioncare, or contact EMME Visioncare to arrange an assessment at The Cathay or Jelita Mall.

References and further reading

International Myopia Institute. IMI 2025 Digest — current evidence relating to environmental factors, near work, screen use, outdoor time and childhood myopia.
International Myopia Institute – IMI 2025 Digest

International Myopia Institute. Clinical Management Myopia Guidelines Report — guidance on near work, viewing distances, breaks and outdoor activity.
International Myopia Institute – Clinical Management Myopia Guidelines

Ha A, Lee YJ, Lee M, et al. Digital Screen Time and Myopia: A Systematic Review and Dose-Response Meta-Analysis. JAMA Network Open. 2025;8(2):e2460026.
PubMed – Digital Screen Time and Myopia

Li D, Min S, Li X. Is Spending More Time Outdoors Able to Prevent and Control Myopia in Children and Adolescents? A Meta-Analysis. Ophthalmic Research. 2024;67(1):393–404.
PubMed – Outdoor Time and Childhood Myopia Meta-Analysis

Health Promotion Board, Singapore. Healthy Eyes, Clear Vision — advice for childhood myopia, near work and outdoor activity.
HealthHub Singapore – Healthy Eyes, Clear Vision

Singapore National Eye Centre. Eye Care Tips — outdoor activity, visual breaks, reading distance and screen-use guidance.
Singapore National Eye Centre – Eye Care Tips

This article provides general educational information and does not replace an individual eye examination or medical advice. Myopia risk and progression vary between children.