Vision disorders in preterm-born children and the additional role of screen time

Aims Preterm-born children are more susceptible to refractive errors like myopia and astigmatism. Lifestyle and digital media play a central part in lives of adolescents; prolonged indoor screen time has adverse visual consequences. Our aim was to measure the prevalence of spectacle wear among preterm-born toddlers and adolescents, and to assess if screen time plays an additional role. Methods We analyzed data from the Longitudinal Preterm Outcome Project (LOLLIPOP) cohort. At age 5, we collected (n=1514) parental information on spectacle wear, screen time (exposure to screens ≥½ hour a day at <30 cm from the monitor), and at age 13-16 adolescent-reported and parent-reported data of a subsample (n=227) on spectacle wear and screen time. Differences between preterm- and full- term-born were assessed using chi-square tests. Results At age 5 the prevalence of spectacle wear among pretermborn (<36 weeks) and full-term born children was 7.7% and 3.2%, respectively (p=0.002). Remarkably, for children who had more screen time the relationship between being preterm and spectacle wear was very significant (p=0.009), whereas this was not significant for children who had lesser screen time (<½ hour a day). We found no association between screen time and spectacle wear in general (p=0.88). In adolescence, the prevalence of spectacle wear was 25.2% and 22.4%, in preterm- and full-term-born, respectively (p=0.66). Conclusions In preterm-born children the risk of spectacle wear at age 5 is increased, and in preterm-born children the relationship with increased screen time is significant. At adolescence we did not find a significant difference between the gestational age groups regarding spectacle wear. Especially in preterm-born children, prevention of increased screen time and early assessment of visual development is warranted to offer timely preventive interventions.