Myopia incidence and lifestyle changes among school children during the COVID-19 pandemic: a population-based prospective study

Abstract

BackgroundThe impacts of social restrictions for COVID-19 on children’s vision and lifestyle remain unknown.AimsTo investigate myopia incidence, spherical equivalent refraction (SER) and lifestyle changes among schoolchildren during the COVID-19 pandemic.MethodsTwo separate longitudinal cohorts of children aged 6–8 years in Hong Kong were included. The COVID-19 cohort was recruited at the beginning of the COVID-19 outbreak, whereas the pre-COVID-19 cohort was recruited before the COVID-19 pandemic. All children received ocular examinations, and answered a standardised questionnaire relating to their lifestyle, including time spent on outdoor activities and near work, both at baseline and at follow-up visits.ResultsA total of 1793 subjects were recruited, of whom 709 children comprised the COVID-19 cohort with 7.89±2.30 months of follow-up, and 1084 children comprised the pre-COVID-19 cohort with 37.54±3.12 months of follow-up. The overall incidence was 19.44% in the COVID-19 cohort, and 36.57% in pre-COVID-19 cohort. During the COVID-19 pandemic, the change in SER and axial length was –0.50±0.51 D and 0.29±0.35 mm, respectively; the time spent on outdoor activities decreased from 1.27±1.12 to 0.41±0.90 hours/day (p<0.001), while screen time increased from 2.45±2.32 to 6.89±4.42 hours/day (p<0.001).ConclusionsWe showed a potential increase in myopia incidence, significant decrease in outdoor time and increase in screen time among schoolchildren in Hong Kong during the COVID-19 pandemic. Our results serve to warn eye care professionals, and also policy makers, educators and parents, that collective efforts are needed to prevent childhood myopia—a potential public health crisis as a result of COVID-19.

The Impact of Study-at-Home During the COVID-19 Pandemic on Myopia Progression in Chinese Children

“…Children's lifestyles have changed among children during the COVID-19 pandemic ( 12 , 30 ). During the study-at-home period, students were away from the school classrooms and engaged in online education, which greatly increased digital screen time.…”

Evaluation of an Optical Defocus Treatment for Myopia Progression Among Schoolchildren During the COVID-19 Pandemic

“…This may explain why the difference between DIMS and SVL groups in the current analysis is lower than in the previous study. 27 It is also worth noting that previous longitudinal studies 14 , 15 on refractive error change during the COVID-19 lockdown were targeting whole cohorts (ie, including children with and without myopia). From the current results on children with myopia, we speculate that the drastic change in environmental risk factors during the lockdown period 4 were associated with myopic shift in people without myopia and myopia progression in those with myopia.…”

“…Although a previous cross-sectional study 28 revealed an increase in myopia prevalence and incidence during the COVID-19 pandemic compared with historical numbers and some recent studies 14 , 15 longitudinally following up total cohorts of children, the current study leveraged data from longitudinal studies that were prospectively conducted during the pandemic in school-aged children with myopia requiring optical correction. Using exploratory, prespecified analyses, the association of lockdown measures on myopia progression was evaluated, in addition to the performance of DIMS spectacle lenses for control of myopia progression during the COVID-19–induced lockdown period.…”

Low‐intensity, long‐wavelength red light slows the progression of myopia in children: an Eastern China‐based cohort

“…pandemic, the myopia rate in primary and middle school students increased by 11.7% over a 6 month period in China (sohu.com/a/41512 7992_105067), while other countries also saw marked rises. [6][7][8][9][10] In particular, the results of a survey released by the Chinese Ministry of Education at the end of August 2020 highlighted the problem of myopia.…”