ArticleOphthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)2026
Digital Eye Behaviour Phenotypes and Their Association with Axial Length and High Myopia in Chinese Adolescents.
Article in Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeScreen exposure is often summarised as total duration, although this aggregate measure obscures important differences in how devices are used. This study sought to identify digital eye behaviour phenotypes and evaluate their associations with axial length (AL) and high myopia.
methodsA school-based cross-sectional study of 898 high school students in Shanghai was conducted. The four-class latent class analysis (LCA) used eight questionnaire-derived indicators of device use. Regression models evaluated exploratory cross-sectional associations with AL and high myopia, adjusting for demographic, familial, sleep and school covariates.
resultsLCA identified four phenotypes differing by screen purpose, weekday-weekend patterns, viewing distance and visual-break behaviour. The entertainment-dominant, weekend-heavy phenotype (11.5%) had the highest entertainment ratio and weekend concentration. The lower-screen, study-oriented phenotype (15.4%) had the lowest total screen time and the highest study ratio. Adjusted AL point estimates relative to the reference phenotype ranged from -0.25 to -0.02 mm. The lower-screen, study-oriented phenotype had nominally higher odds of high myopia (adjusted odds ratio = 1.90; 95% CI, 1.06 to 3.39; p = 0.03). This association was attenuated in the attention-check-correct subset. Mean AL was 24.83 ± 1.20 mm; mean worse-eye spherical equivalent was -3.35 ± 2.36 D and 115 students (12.8%) had high myopia.
conclusionsFour digital eye-behaviour phenotypes captured multidimensional exposure heterogeneity beyond total duration. These profiles provide a framework for prospective studies of whether behaviour combinations relate to refractive development beyond total duration.
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