**5. Conclusions**

The public health consequences stemming from a pandemic can be both wide-ranging and long-lasting, affecting not only the most vulnerable, but also leave its mark on the next generation in profound ways. In this study, we identified the less-visible vision health concerns on young children as many education systems have transitioned to remote online instruction due to the COVID-19 pandemic. Most strikingly, near-vision e-learning device use is a critical source affecting myopia development, and the associated youth health risks, as well as appropriate mitigation strategies, need to be seriously considered, should remote learning programs continue due to prolonged future waves of the COVID-19 pandemic.

**Author Contributions:** J.L., Q.C., and J.D. conceived, conceptualized, and designed the study. J.L. and Q.C. contributed to data collection and conducted the statistical analysis. J.L., B.L., and Q.C. drafted the article and contributed to interpretation of results. All authors have revised the manuscript for important intellectual content. All authors have read and agreed to the published version of the manuscript.

**Funding:** This work was supported by the National Social Science Foundation of China (CJA200256) and Shaanxi Normal University RenCai Faculty Seed Fund (1301031829).

**Institutional Review Board Statement:** The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board (76909767).

**Informed Consent Statement:** All subject consent was obtained.

**Data Availability Statement:** Restrictions apply to the availability of data used, due to study subject privacy protection. Data was obtained from Teachers Daily and is available upon request with the permission of Teachers Daily.

**Acknowledgments:** We thank Xiangna Kong and Xiaoli Feng at Teachers Daily for data collaboration.

**Conflicts of Interest:** The authors have no conflicts of interest to disclose.

#### **References**

