Healthy vision plays an important role in our daily lives [1]. However, a seminal study indicated that the globally estimated prevalence of myopia has reached 1.4 billion in 2016 and is predicted to increase to 4.8 billion by 2050 [2]. The earlier onset of myopia is of particular concern, as it has been positively linked to the progression and development of vision-threatening complications (e.g., myopic macular degeneration) [3], and may also lead to an elevated prevalence of psycho-social-behavioral problems (e.g., stress, depression, anxiety, learning disabilities, and social barriers) [[4], [5], [6]]. Previous studies indicated a high prevalence of prescribed eyeglasses/contact lenses in children and adolescents [[7], [8], [9]]. For example, 25.3% of children and adolescents (aged between 2 and 17 years) used prescription eyeglasses and/or contact lenses in the United States (U.S.) [7], 29.2% of adolescents (aged between 14 and 17 years) were prescribed eyeglasses/contact lenses in Germany [8], and at least 30% of children (aged between 6 and 7 years) were prescribed eyeglasses/contact lenses in the Netherlands [9].

A growing amount of evidence suggests that lifestyle behaviors (e.g., physical activity [PA], sedentary-based screen time [ST] and sleep duration [SL]) can influence myopia. Although this evidence favors a positive influence of specific movement factors, results are not univocal [[10], [11], [12]]. For example, a study in school children (aged between 6 and 13 years) indicated that regular PA reduced the likelihood of being prescribed eyeglasses [13]. Contrastingly, a systematic review indicated that PA was a non-significant risk factor for myopia [11]. Of note, with the advancement in digital devices [14], the high amount of ST has been consistently reported in children and adolescents, which, in turn, constitutes a strong risk factor for vision health [[15], [16], [17]].Conversely, some researchers found a weak or absent association between myopia and ST [18,19]. Researchers also investigated the role of sleep in the development of myopia. For instance, some studies observed that lower SL was linked to a higher prevalence of myopia among school-aged children and adolescents [[12], [20]], whereas other studies did not find evidence for such a relationship in a similar age group [[21], [22]]. Overall, the mixed evidence on the effects of movement behaviors on vision health (e.g., myopia) necessitates further research so that more nuanced lifestyle recommendations can be made to prevent the onset of being prescribed with eyeglasses/contact lenses.

In 2016, the Canadian 24-hour movement behavior (24-HMB) guidelines were published to promote a healthy development of children and adolescents [23]. In particular, the 24-HMB guidelines integrate recommendations for movement behaviors within a 24-hour cycle, including recommendations on PA, sedentary behavior (typically referring to ST in children and adolescents), and SL. Researchers typically consider both independent components (categorical 24-HMB) and combined components (continuous 24-HMB), as 24-hour behaviors along the movement continuum (PA, ST and SL) always cluster and interact, such that their combined effects exceed the individual contributions of each behavior [23]. As reported, meeting the 24-HMB guidelines may have important implications for health at all ages and are associated with superior health outcomes (e.g., quality of life) among children and adolescents [[24], [25]].

In this regard, the associations between meeting the 24-HMB guidelines and the wearing eyeglasses/contact lenses has yet to be reported. Therefore, the aim of this study was to investigate in a nationally representative sample of U.S. children and adolescents aged between 6 and 17 years whether meeting the 24-HMB guidelines might influence the risk of being prescribed eyeglasses/contact lenses. We hypothesized (i) that meeting the 24-HMB guidelines is associated with a lower risk of being prescribed eyeglasses/contact lenses, and (ii) that older children and girls would be more likely to be prescribed to wear eyeglass/contact lenses in relative to their reference groups.