Implementing real-time intervention on reading habits and monitoring outdoor activities for myopic children

Introduction: Myopia, or near-sightedness, has become a global epidemic, particularly among children. This study investigates the relationship between myopia and environmental factors, focusing on reading habits in myopic children. The objective is to assess the effectiveness of Clouclip, an intelligent wearable device, in monitoring and intervening in myopia-related behaviors. Methods: Seventy-one myopic students (aged 10–14) from three schools in Wuhan, China, participated in the study. Informed consent was obtained, and ethical approval was granted. Inclusion criteria specified participants wearing glasses, parental cooperation in Clouclip data upload, voluntary participation, daily glasses wearing from 8:00 am to 21:00 pm, and refractive error ranging from − 0.5D to -6D. Exclusion criteria included abnormal intraocular pressure, eye diseases, prior myopia control methods, systemic diseases, and high myopia in parents. Ocular biological data were measured, including cycloplegic autorefraction, axial length, and intraocular pressure. Clouclip: Clouclip, a wearable sensor, measured reading behavior parameters such as outdoor activity time, reading time, illuminance, and reading distance. Data were collected for two months to assess changes in behavior. Statistical Analysis: Statistical analysis utilized SPSS version 25.0. Shapiro-Wilk tests, correlation coefficients, Mann-Whitney U tests, paired t-tests, and Wilcoxon rank sum tests were employed as appropriate. Results: Baseline characteristics showed a mean cycloplegic SER of -3.1D. Initial Clouclip data revealed no significant relationship between cycloplegic SER and environmental factors. After two months, visual distance showed a significant decrease (p = 0.017). Other factors, including reading illuminance, outdoor time, and reading time, did not exhibit statistical significance. Discussion: This study found that cloud-clip intervention can change eye-use behavior, but it cannot change the impact of the social environment.