Preventive Effectiveness of Distant-Image Screen Display Toward Accommodative Lag and Nearwork-Induced Transient Myopia: A Self-Controlled Study

Background: Nearwork was the primary cause of myopia and it was difficult to be reduced due to the need of teaching. We develpment the distant-image screen (DIS) which can simulate looking far away on a child’s study table. This research aimed to assess its effectiveness in preventing nearwork-induced transient myopia and accommodative lag.Methods: In this self-controlled study, subjects were randomly divided into two groups by a central computer system. The first group watched a 10 minutes video on the tablet and then watched the same video for 10 minutes on the DIS after a 30 min break. The second group watched the video in reverse order. The diopters before video viewing, the accommodative lag at the start of viewing and 5 min of viewing, the nearwork-induced transient myopia at the end of viewing were measured by a open phoropter.Findings: Between Jun 6, 2020, and Jun 30, 2021, 62 volunteers (mean age: 28 years, 95% CI 18 to 38) were recruited. The diopters before viewing tablet and DIS were −0.31D (-1.28 to 0.65) and −0.28D (-1.32 to 0.76), respectively, with no significant difference (p=0.735). At the start of video viewing, the accommodative lag of the wathching tablet was 0.59D ( -1.28 to 2.45) and that of DIS was 0.01D (-1.15 to 1.17), with a significant difference (p<0.001). After 5 min of video viewing, the accommodative lag of wathching tablet was 0.67D (-0.92 to 2.26) and that of DIS was 0.06D (-1.12 to 1.24), with a significant difference (p< 0.001). After video viewing was completed, the nearwork-induced transient myopia of wathching tablet and DIS were 0.19D (-0.32 to 0.70) and 0.03D (-0.36 to 0.42), respectively, with a significant difference (p<0.001).Interpretation: The DIS can significantly prevent nearwork-induced accommodative lag and transient myopia by simulating the view distance from near to far, indicating the potential of this device to prevent the occurrence and development of myopia.Funding: Beijing Municipal Science and Technology Project (Z201100005520042)Declaration of Interest: No conflicting relationship exists for any authorEthical Approval: The research was approved by the Human Studies Committee at Beijing Tongren Hospital (Beijing, China) in accordance with the Declaration of Helsinki and the Code of Ethics of the World Medical Association