Impact of COVID-19 Home Confinement in Children’s Refractive Errors

Abstract

Background: Myopia is a public health problem, with estimations that 50% of the world population will be myopic by 2050. Some environmental factors, such as time spent outdoors, doing near work, and using digital devices, influence the development of myopia in children. Home confinement in Spain has increased these risk factors, so this study aims to investigate the impact of home confinement during the COVID-19 outbreak in the vision of school-aged children; Methods: A cross-sectional study in children between 5 and 7 years old that completed a visual screening and a questionnaire about their lifestyles at opticians in Spain in September and October of 2019 and 2020. Statistical analysis to compare lifestyles pre and post confinement, and vision in 2020 versus a similar cohort examined at the same opticians in 2019, was conducted; Results: Spanish children spent less time outdoors and more time doing near work in 2020 than in 2019 (p ≤ 0.001). There was a significant decrease of the spherical equivalent (mean ± standard deviation; 0.66 ± 2.03 D in 2019 vs. 0.48 ± 1.81 D in 2020; p ≤ 0.001); Conclusions: Lifestyles of Spanish children changed during the home confinement at the beginning of 2020. Together with changes in their lifestyles, spherical equivalents have decreased, which implies higher figures of myopia for children aged between 5 and 7.

Digital device overuse during the COVID-19 pandemic and visual impairment among children: Is there a risk for long-term effects?

“…This cross-sectional study analyzed the results obtained during the "scholar campaign in favor of the visual health" carried out in 2019 and 2020 among the children aged 5-7 years. They came to similar conclusions (36).…”

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.…”

“…In our study, we found that children spent 1.75 ± 0.71 hours per day on online education and 4.33 ± 1.04 hours per day on near work. In Spanish and Hong Kong, children spent more time on near work, and the students from Hong Kong spent nearly 7 hours/day on digital screens ( 12 , 30 ). Long-term near work is considered a risk factor for the prevalence and incidence of myopia through increased accommodative demand ( 8 , 10 ).…”

“…Insufficient time spent outdoors, and prolonged near-work activities are recognized as important risk factors for myopia ( 7 , 10 ). Studies have found that the COVID-19 leads to beneficial conditions for behavioral changes in myopia, characterized by reduced outdoor activity and increased near work ( 11 , 12 ). Children use electronic devices for virtual education, social interaction, and entertainment during the COVID-19 pandemic, with the amount of time Hong Kong children spend on electronic devices increasing from 2.5 h a day to nearly seven hours a day ( 11 , 13 ).…”

Coronavirus disease 2019 outbreak and associated public health measures increase the progression of myopia among children and adolescents: Evidence synthesis

“…28 The students learned from home and communicated using social networking platforms, which resulted in increased use of digital screens and decreased outdoor activity. 29 , 30 Zhao's study in China showed that most children spent more than 3 h daily using digital screens and less than 2 h per day in outdoor activities. 31 Francisco et al demonstrated that the pattern of digital screen use and daily physical activity significantly differed before and during the COVID‐19 pandemic.…”