No screen time for children aged 0–3; limit it as much as possible for ages 3–6; for school‑age kids, non‑educational screen use should not exceed one hour per day.

5. No screen time for children aged 0–3; limit it as much as possible for ages 3–6; for school‑age kids, non‑educational screen use should not exceed one hour per day.

Cost: There is no monetary cost. The real challenge is keeping screens out of children’s hands and encouraging parents to cut down on their own screen time in front of them.

In plain terms: The Health Commission has set strict guidelines: no screens for children aged 0–3, and they should be kept away from screens as much as possible for ages 3–6. For school‑age students, non‑educational screen use must be limited to no more than 15 minutes at a time and no more than one hour per day. The reasoning is that prolonged close‑up screen exposure depletes a child’s “far‑sightedness reserve,” leading to earlier onset of myopia. Research linking screen time directly to myopia isn’t as conclusive; the strongest evidence comes from studies showing that two hours of outdoor activity per day helps prevent myopia.

Benefit: Article 4 of the “Ten Core Principles for Preventing Myopia in Children and Adolescents” states: “Children aged 0–3 should not use smartphones, tablets, computers, or other screen‑based electronic devices; children aged 3–6 should avoid such devices as much as possible; for school‑age students, non‑educational screen use should be limited to no more than 15 minutes at a time and no more than one hour per day.” It also notes that “prolonged close‑up use of screen devices can deplete a child’s far‑sightedness reserve, a key factor in the early and frequent occurrence of myopia.” In 2018, eight government agencies, including the Ministry of Education, issued similar recommendations, adding that “the younger the child, the shorter the recommended continuous screen time.” Scientific research is far less definitive: a systematic review examined 33 studies involving participants from 3 months to 33 years of age; only 11 contributed to the pooled analysis. When only smartphones and tablets were considered, the odds ratio for myopia was 1.26 (95 % CI 1.00–1.60, I² = 77 %). Including computers raised that figure to 1.77 (1.28–2.45, I² = 87 %). The authors concluded only that there may be a link, noting that none of the 33 studies measured screen time reliably.

Evidence grade: B

Sources: National Health Commission of China (NHC) General Office (2023). Ten core knowledge for preventing and controlling myopia in children and adolescents (National Health Office Maternity and Child Letter [2023] No. 278). <https://www.gov.cn/zhengce/zhengceku/202307/content_6894284.htm>; Ministry of Education of China and eight other departments (2018). Comprehensive Implementation Plan for Preventing and Controlling Myopia in Children and Adolescents (Jiao Ti Yi [2018] No. 3). <http://www.moe.gov.cn/srcsite/A17/moe_943/s3285/201808/t20180830_346672.html>; Foreman J, Salim AT, Praveen A, et al. (2021). Association between digital smart device use and myopia: a systematic review and meta-analysis. The Lancet Digital Health, 3(12), e806-e818. <https://doi.org/10.1016/S2589-7500(21)00135-7>; Madigan S, McArthur BA, Anhorn C, Eirich R, Christakis DA (2020). Associations between screen use and child language skills: a systematic review and meta-analysis. JAMA Pediatrics, 174(7), 665-675. <https://doi.org/10.1001/jamapediatrics.2020.0327>

Notes: This recommendation earned a B rating because it is based on official policy directives rather than experimental data. The lower bound of the pooled odds ratio sits right at 1.00, and the authors only describe the relationship as “possible,” so it should be viewed as a practical family guideline rather than a guarantee that avoiding screens eliminates myopia risk. The strongest evidence for prevention comes from Recommendation 4 (two hours of outdoor activity daily). Regular eye examinations are also advised for preschoolers: the same document recommends periodic refraction screening for ages 1–3, 4–6, and older to assess remaining far‑sightedness reserve; details are provided in Recommendation 12 (pupil dilation refraction). Finally, a meta‑analysis of 42 studies involving 18,905 participants found that longer screen time correlates with weaker language development (r = −0.14, 95 % CI −0.18 to −0.10). However, watching educational content on screen shows a positive correlation (r = 0.16 and 0.13). This is a correlation, not causation; it simply underscores that substituting screen time for direct interaction with caregivers is less beneficial for language growth.