Objective To develop an eye health behavior assessment scale for children after keratoplasty and to provide reference for targeted intervention. Methods Literature review and interviews were performed to develop the initial item pool,20 experts were consulted to form the initial scale, and then 714 children who had undergone keratoplasty were investigated for testing the reliability and validity of the scale. Results A 48-item scale assessing 5 dimensions of duration of eyes use, environment of eyes use, behavior of eyes use, diet and exercise, as well as glass use behavior, was identified through exploratory factor analysis, which could explain 60.075% of the total variance. The Cronbach′s alpha coefficient for the overall scale was 0.885 and for dimensions ranged from 0.738 to 0.891. The scale-level content validity index (CVI) was 0.937,and the item-level CVI was between 0.845 and 1.000. Conclusion The scale is reliable and valid to evaluate eye health behavior of children undergoing keratoplasty.