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Preprint Review

How to Save Eyesight: Recommendations from a Review Studies.

DOI: 10.20944/preprints202509.2234.v1

General Overview

The paper provides a narrative review of studies concerning myopia  in children, emphasizing ergonomics, environmental factors, and behavioral influences such as reading distance, posture, and screen time. The paper synthesizes findings primarily from Asian populations, where myopia prevalence is highest, to propose global recommendations for prevention.

Strengths

1. Timely and relevant topic. The rising prevalence of childhood myopia, especially post-COVID-19, is a pressing global health issue.

2. Comprehensive literature inclusion: The paper summarizes 22 studies of varying study designs, mostly from high-quality journals, addressing different dimensions of myopia: genetics, posture, sleep, school environment, and preventive interventions.

3. Practical recommendations: the discussion section translates evidence into actionable prevention strategies, such as, limiting near work duration time, adjusting school furniture ergonomically, encouraging outdoor time, encouraging adequate sleep and reducing academic pressure.

4. Cross-disciplinary insight: the integration of physiotherapy and biomedical engineering perspective gives the paper a unique focus on ergonomics, often underrepresented in ophthalmic research.

Weaknesses and Areas for Improvement

1. Methodological Transparency: the methodology does not demonstrate the rigor expected of a systematic or meta-analysis. The study selection process is not supported by a PRISMA flow diagram or inclusion/exclusion criterion beyond age group. There’s no quality assessment of the included studies (e.g., using GRADE or NEWCASTLE-Ottawa tools).

2. Data Synthesis: The results are narrative summaries without quantitative synthesis (e.g., pooled prevalence or  Odds ratios). The meta-analysis data presentation mentioned in the abstract is not actually performed. This may mislead readers about the paper’s analytical depth. The meta-analysis data including pooled estimates and forest plots

3. Regional Bias: The evidence base is almost entirely Asian (especially Chinese). While justified by high prevalence, the paper generalizes findings globally without considering sociocultural or environmental differences in non-Asian contexts.

Formatting and Language

1.The manuscript has several grammatical and structural errors. For example the title “Recommendations from a Review Studies” should be revised for grammatical correctness to for example “Recommendations from Review Studies” or A Review of Strategies to Save Eyesight”.

2.Scientific Depth: The discussion lacks critical comparison between conflicting studies (e.g., reading posture-lying down vs. sitting).

3.Citation and Referencing: Some references are incomplete or not consistently formatted (e.g., missing page ranges, inconsistent capitalization). The authors could have utilize reference management tool e.g., Zotero or EndNote to streamline the references.

Recommendations for Improvement

1. Clarify Review Type:  structure the paper appropriately to be either systematic review, scoping review or narrative synthesis. And include a clear search strategy, inclusion/exclusion criteria, and data extraction framework.

2. Improve Analytical Rigor: Add a table summarizing key study characteristics (country, sample size, age, outcome, quality rating). Consider conducting a basic quantitative synthesis or provide forest plots to visualize trends.

3. Enhance Scientific Discussion: Discuss casual pathways (e.g., why outdoor light exposure protects vision). Highlight policy implications (e.g., school design, screen use guidelines). Compare with non-Asian data to enhance generalizability.

4. Reformat manuscript according to journal guidelines, add missing figures and ensure consistent reference formatting.

Publication: Major Revision before submission to peer-reviewed journal.

Reviewers:

 Murtala Haruna Bawa Allah  https://orcid.org/0000-0002-1435-4032

Juliet Gamuchirai Nyamasve  https://orcid.org/0009-0001-3152-8567

Competing interests

The authors declare that they have no competing interests.

Use of Artificial Intelligence (AI)

The authors declare that they did not use generative AI to come up with new ideas for their review.