Technology addiction as a predictor of visual problems in early adolescents: a multicentre case–control study

Abstract

Increasing screen exposure among early adolescents has raised concerns regarding technology addiction and its potential impact on visual health. Within the scope of primary health care, early identification of modifiable behavioural risk factors is essential for preventive intervention. This case–control study examined the association between technology addiction and visual problems among early adolescents and explored implications for primary health care and school health services. The study included 585 students in grades 5–8 from three randomly selected public middle schools. The case group comprised 47 students diagnosed with visual impairment or wearing corrective lenses, while the control group included 538 students without visual problems. Data were collected via face-to-face interviews using a Personal Information Form and the Technology Addiction Scale. Logistic regression analysis was conducted to determine predictors of visual problems. Students with visual problems demonstrated significantly higher total technology addiction scores and higher subdimension scores for social media use, instant messaging, online gaming, and website browsing (p <.001). Longer daily screen time and irregular sleep patterns were associated with increased addiction levels. Gender differences were observed: girls scored higher in instant messaging and website use, whereas boys scored higher in gaming addiction. Online gaming duration and total addiction scores were significant predictors of visual problems. Technology addiction, particularly excessive gaming exposure, appears to be a modifiable risk factor for visual problems in early adolescence. Integrating digital hygiene education, screen-time monitoring, and behavioural risk assessment into primary health care and school nursing practice may contribute to early prevention and health promotion strategies. © The Author(s), 2026. Published by Cambridge University Press.