Refractive Error Changes Due to COVID-19 Pandemic Confinement in Children from Puerto Rico: A Retrospective Study

Abstract

Significance The progression of myopia increased in children after the pandemic confinement. A myopic shift in the refractive error of the Hispanic population was found regardless of the refractive status of the school-aged children studied. Purpose This study aimed to evaluate the refractive error in Puerto Rican children before and after the COVID-19 pandemic. We were interested in whether there was a significant change in refractive error attributed to online learning during the pandemic lockdown. Methods A retrospective record review of children aged 7 to 18 years that underwent a comprehensive visual evaluation between 2018 and 2021 at the Inter American Eye Institute in Puerto Rico. The spherical equivalent pre- and post-lockdown were compared. The study excluded the best corrected visual acuities worse than 20/40, any corneal or retinal disease, and amblyopia. Results In total, 801 records were included in this study. The mean age was 12.7 ± 3.2, with (50.3%) males and (49.7%) females. The mean spherical equivalent for the right and left eyes was similar (r = .93, P ≤ .001). A significant difference in the mean spherical equivalent was found pre and post-lockdown (0.22 ± 0.59 D, t(800) = 10.44 P ≤ .001). A myopic shift post-lockdown was significant for all ages except those in the seven (0.13 ± 0.79 D, t(28) = 0.84, P = .40) and 8-year-old range (0.12 ± 0.65 D, t(40) = 1.22, P = .23), respectively. No significant change was found between genders pre (0.16 ± 0.12 D; t(799) = 1.38, P = .16) and post (0.15 ± 0.13 D; t(799) = 1.19 P = .23) confinement. Conclusions The current study revealed a significant myopic shift in Hispanic school-aged children as a result of the pandemic confinement.