Association Between Parental Attitudes Towards Screen Time and Children's Language Skills in Four European Countries.

The global aging trend is substantially increasing the burden of vision impairment. In 2020, an estimated 295 million people had moderate-to-severe vision impairment (MSVI), over 70% of whom were aged 50 years or older. In China alone, approximately 59 million individuals live with vision impairment, of whom 80% are aged 50 or above and 40% are aged 70 or older. Vision impairment in older adults extends beyond functional loss, as it restricts participation in outdoor and social activities, limits access to health care, and is associated with elevated risks of depression, anxiety, and cognitive decline. Although many causes, such as refractive error and cataract, are treatable with existing interventions, significant barriers, including inequitable access to eye care and limited health literacy, often delay diagnosis and treatment, leading to irreversible vision loss. In practice, subjective visual disturbance (SVD), which refers to symptoms such as blurred vision, floaters, or visual distortion (International Classification of Diseases, 10th Revision, code H53.1), remains the primary trigger for older adults in China to seek ophthalmic evaluation. However, the reliability of SVD as an indicator of clinically significant ocular disease remains unclear. Objective vision impairment (OVI), defined by standardized visual acuity testing, typically reflects underlying eye conditions requiring clinical attention. Notably, some older adults exhibit OVI without reporting SVD, which may delay diagnosis, while others report SVD in the absence of measured OVI, potentially reflecting early ocular changes or non-ophthalmic conditions. This discordance highlights a critical gap in understanding real-world visual health perception and clinical need. Elucidating the status and associated factors of OVI–SVD discordance is therefore essential to optimize vision care strategies for aging populations. Using baseline data from the Proactive Ophthalmic Examination Cohort (POEC) in Guangzhou, China, this study aims to investigate the prevalence and associated factors underlying OVI–SVD discordance within a population characterized by relatively high medical accessibility and health consciousness. This setting provides a unique opportunity to assess the persistence of such discordance when structural barriers to care and general health neglect are minimized. By evaluating both individual- and eye-level factors, this study aims to inform targeted screening approaches and health policy initiatives to improve early detection and management of vision impairment in older adults.