Background:The global prevalence of myopia has risen significantly, particularly among school-aged children. Increased screen time exposure due to digital learning and recreational device use has been identified as a potential risk factor. However, longitudinal data evaluating this association remain limited. This study aims to investigate the correlation between daily screen time and the incidence of myopia in children aged 6 to 14 years. Materials and Methods:A prospective cohort study was conducted over 12 months involving 500 school-aged children without pre-existing myopia at baseline. Participants were categorized into three groups based on their average daily screen time: Group A (<2 hours/day), Group B (2–4 hours/day), and Group C (>4 hours/day). Comprehensive ophthalmologic examinations, including cycloplegic refraction, were performed at baseline, 6 months, and 12 months. Data on screen time exposure were collected through validated parental questionnaires and digital device usage logs. The incidence of myopia was defined as a spherical equivalent refractive error of ≤ -0.50 diopters in either eye. Statistical analysis was performed using Cox proportional hazards models to assess the risk association. Results:At the end of the study period, the cumulative incidence of myopia was 8% in Group A, 18% in Group B, and 32% in Group C. Children with screen time exceeding 4 hours/day (Group C) demonstrated a significantly higher risk of developing myopia compared to Group A (Hazard Ratio [HR]: 3.5; 95% CI: 2.1–5.8; p< 0.001). A dose-response relationship was observed between increasing screen time and myopia incidence. Adjustments for confounding factors such as outdoor activity and parental myopia did not significantly alter the outcomes. Conclusion:Prolonged screen time is strongly associated with an increased incidence of myopia among school-aged children. These findings highlight the need for public health strategies focusing on limiting screen exposure and promoting outdoor activities to mitigate the risk of early-onset myopia.