Previous studies have mainly focused on the impact of myopia and anxiety on the social emotions of individual patients, as well as the emotional changes of patients before and after surgery [6,7,8,9,10]. However, in-depth study on the emotional changes of parents caused by children’s myopia is still lacking. In clinical practice, it is common to see parents of children with myopia tend to exhibit significant anxiety and tension. These emotions may lead them to overestimate the risks of myopia, spend a lot of money on expensive equipment, or take too many unnecessary treatment measures, thus complicating simple issues. In order to further explore the impact of children’s myopia on parents’ emotions and provide effective psychological counseling, this study was conducted.

The questionnaire used in this study exhibited excellent reliability and validity, aligning with prior research that supports the robustness of the Beck Anxiety Inventory in assessing anxiety levels [4, 11]. Analysis of the BAI items indicated that excessive worry, trembling, and feelings of nervousness were particularly prominent among parents with moderate to severe anxiety. These key symptoms reflect the cognitive preoccupations and physical manifestations of anxiety that may stem from concerns about their children’s long-term visual health and academic performance. Targeted interventions addressing these specific symptoms could be more effective in reducing parental anxiety. For instance, cognitive-behavioral strategies that focus on managing excessive worry and physical relaxation techniques could be integrated into myopia management programs to provide comprehensive support for affected parents.

Compared with other mainstream anxiety assessment tools such as the Self-rating Anxiety Scale (SAS), the Hamilton Anxiety Scale (HAM-A), the Generalized Anxiety Disorder 7-item Scale (GAD-7), and the Multidimensional Anxiety Scale for Children (MASC), the BAI performs better in terms of coverage of anxiety symptoms, ease of assessment, and ability to complete the assessment independently. The items of SAS and GAD-7 are relatively straightforward, HAM-A relies on clinical scoring, and MASC is mainly targeted at children, so the BAI is more suitable for assessing parents’ anxiety caused by their children’s myopia [11, 12]. While the BAI was chosen for its comprehensive and user-friendly nature, it is important to acknowledge its limitations. The BAI primarily focuses on physiological symptoms of anxiety, which may lead to an overestimation of anxiety levels in individuals who exhibit significant physiological responses but less cognitive anxiety. Additionally, self-reported measures like the BAI are subject to response biases, including social desirability and subjective interpretation of symptoms. Future studies might consider complementing BAI with other instruments or qualitative assessments to provide a more nuanced understanding of parental anxiety.

This study explored the impact of children’s myopia on parental anxiety by analyzing 242 questionnaires. The main survey respondents were mothers, accounting for 74.4%, indicating that mothers bear a greater responsibility in the management of their children’s health. Among the parents interviewed, most were aged under 40 (65.29%), followed by over 40 (34.71%). Regarding the anxiety level, 64.46% of parents had no anxiety symptoms, with a median anxiety score of 4 and an average score of 8.22 ± 11.34, indicating that the vast majority were in a state of no or low anxiety. 8.68% of parents showed severe anxiety, which may be related to the severity of their children’s myopia, the complexity of treatment, and the uncertainty of visual development. They may need further psychological counseling. Our findings reveal that approximately 18.18% of parents of myopic children experience clinically significant anxiety levels (moderate to severe). These results underscore the critical need for integrating mental health support into myopia management programs. Addressing parental anxiety is essential not only for the well-being of the parents but also for the effective management and prevention of further myopia progression in children. Healthcare providers should consider psychological counseling as a component of comprehensive myopia treatment plans to alleviate parental anxiety and promote a supportive environment for children’s vision health. These results also show that society’s awareness of the universality and controllability of myopia has increased, leading parents to respond more rationally. However, parents with a high anxiety level may be concerned about their children’s academic performance, health, and future career choices, especially in East Asia. In the future, psychological support and health education for parents should be strengthened to help them better understand and deal with their children’s myopia issues, thereby reducing their psychological burden.

Our study found that mothers, compared to fathers, primarily undertook the responsibility of childcare in the family, and were therefore more likely to experience anxiety towards their children’s myopia. In addition, parents aged under 40 had a higher anxiety level, which may be due to the heavier life pressure they have endured and the higher expectations they have had for their children. The degree of myopia of parents also affected their anxiety level. Those parents with the myopia defree between −0.25D and −6.00D were more concerned about their children’s myopia due to personal experience [13]. Anxiety towards girls may be related to cultural background and the emphasis on gender roles. When children’s myopia were in the early stage of −0.25D to −3.00D, parents’ anxiety began to increase. If not treated in time, the issue may further deteriorate. Especially for school-age children aged 7 to 10, parents were worried that myopia may affect their children’s academic performance. And this period is also a critical stage for myopia prevention and control, so more attention needs to be paid [14].

Further difference analysis revealed that the degree of children’s myopia was a significant factor affecting parental anxiety. The study pointed out that mothers were more likely to experience anxiety than fathers, possibly because they have bore more responsibilities in childcare. Although the myopia degree of parents, the gender and age of children had no significant impact on the anxiety of parents, when the myopia degree in children were higher (−3.00D to −6.00D), the parental anxiety level increased significantly (P < 0.05). This indicates that high myopia poses a greater threat to children’s health, thus requiring more support to alleviate parental anxiety and optimize children’s vision management. In addition, the earlier children develop myopia, the more parents tend to feel anxious. Although the statistical data did not show significant differences, the trend was still very clear.

Our study found that mothers, compared to fathers, were affected by their anxiety about their children’s myopia more significantly. Although the majority of parents had no significant anxiety, 8.68% of parents felt severe anxiety due to their children’s myopia. In fact, the severity of children’s myopia is the only significant factor affecting the anxiety of parents. In contrast, the positive correlation (r = 0.186) between the degree of children’s myopia and parental anxiety levels suggests a small to moderate association, other factors such as parental age, gender, and parental myopia status did not show significant associations with anxiety levels. These non-significant results suggest that, within our sample, these factors may not independently influence parental anxiety, or that the study may have been underpowered to detect such associations.

In addition, there are some limitations in this study, such as the limited number of samples, and some parents participated in the survey after their children had been myopic for some time, which may lead to a relatively lower anxiety level, thus affecting the accuracy of anxiety scores. The BAI scores exhibited a right-skewed distribution with substantial variability, which may have compromised the assumptions of the t-tests and chi-square tests used in our analysis. Although we applied a natural log transformation and collapsed anxiety categories to address these issues, the adjusted analyses did not yield significant results, potentially due to the limited sample size and high variability. Future research should consider larger and more homogeneous samples, as well as employing non-parametric statistical methods, to more accurately detect associations between parent and child factors and parental anxiety levels.

In summary, the impact of children’s myopia on parents’ emotions cannot be ignored. It is recommended to provide appropriate psychological support to help parents manage their emotions more effectively, thereby helping to control the further development of children’s myopia.