Abstract
WHAT IS ALREADY KNOWN ABOUT THIS TOPIC? Insufficient hyperopic reserve serves as a preclinical indicator of myopia development and is influenced by socioeconomic factors and behavioral patterns. However, region-specific risk profiles remain inadequately characterized. WHAT IS ADDED BY THIS REPORT? This nationwide investigation demonstrates substantial regional heterogeneity in myopia risk factors. Children residing in low-gross domestic product (GDP) regions exhibit significantly stronger associations between screen time usage and poor screen habits with insufficient hyperopic reserve. This relationship is most pronounced among girls in low-GDP areas. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE? Public health interventions should prioritize targeted screen use guidance for children, particularly girls in socioeconomically disadvantaged regions, to effectively protect visual health and prevent myopia progression.