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This study examined the association between smart device usage and the 1-year change in refractive error among a representative sample of Hong Kong children and adolescents aged 8-14 years. A total of 1597 participants (49.9% male, mean age 10.9, SD 2. who completed both baseline (2017-2018) and 1-year follow-up (2018-2019) eye examinations were included in the present study. The non-cycloplegic auto-refractive error was measured and the average spherical equivalent refraction (SER) was analyzed. The participants also self-reported thei
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