Developing Virtual Reality Mini-Games for Myopia Prevention Habit Training in Chinese Primary School Children: Design, Implementation, and Pilot Evaluation

China is facing a major childhood myopia crisis, with over 53% of school-aged children affected and nearly 92% at the university level. Current school-based programs, especially the required 眼保健操 eye exercise initiative, often struggle with low compliance. This is due to a lack of interactive feedback and rewards. This paper discusses the design, implementation, and initial evaluation of Eye Guardian, a virtual reality (VR) game system featuring three 60-second mini-games: Dragon Chase (which focuses from near to far), Blink Rain (which promotes regular blinking), and Cloud Valley (which provides structured visual breaks). Each mini-game includes a recognized behavior for preventing myopia, presented in a culturally relevant way for Chinese primary school children aged 6 to 12. The prototype was created using Unity 2022 LTS on the Meta Quest 3 standalone headset. It offers bilingual Chinese–English interfaces, incorporates traditional Chinese architectural designs, and uses a unified system for tracking behavior. The pilot evaluation involved 10 participants for the System Usability Scale and 13 for the behavioral intent survey. It resulted in an average System Usability Scale score of 77.5 (SD = 19.5), which falls within the "Good" usability range. Behavioral intent ratings were above 4.0 out of 5.0 across various areas, with cultural relevance scoring the highest consensus (M = 4.69). Gameplay log analysis from 23 internal testing sessions showed reliable data capture. It also indicated a learning effect in Dragon Chase and Blink Rain. To our knowledge, this is the first VR serious game system specifically designed for myopia prevention rather than treatment in Chinese primary school children. The findings suggest that culturally relevant, game-based technologies for eye health can effectively support existing school health programs.

myopia prevention; virtual reality; serious games; children

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