Prevalence of Myopia and Associated Risk Factors Among Primary Students in the Period of Online Study During COVID-19: A Cross-Sectional Study in Guangzhou

Abstract

Introduction: To investigates the impact of online study during COVID-19 on myopia in Chinese primary school students and to further analyze the influencing factors of myopia, so as to provide theoretical basis for prevention and control of myopia. Objectives: Cross-sectional study. A total of 905 primary school students from grade 1-6 in Guangzhou city were included in the study. Data were collected from uncorrected visual acuity (UCVA), non-cycloplegic photo refraction and an online questionnaire. Myopia was defined as visual acuity < 1.0 or spherical equivalent (SE) of ≤ − 0.50 diopters (D) in either eye. Chi-square and binary logistic regression analysis were applied to investigate the prevalence of myopia for different groups and potential risk factors on myopia. Results: A total of 905 students were evaluated. The mean (standard deviation) age was 9.7(±1.82) years. 699 students were identified to have myopic refractive error making the prevalence of 77.2% ([95% confidence interval (CI): 75.5%-80.0%]; myopia prevalence significantly increased with grade level, from 61.9% (95% CI: 54.0%-69.8%) at grade 1 to 84.0% (95% CI: 80.5%-90.1%) at grade 6. Low myopia (-3.0 D≤ SE ≤ -0.50 D) was account for 83.5% (95% CI: 80.3%-86.3%) among the myopia group, with the mean (standard deviation) SE (-1.32±0.66) D. Compared with children without myopia, the dry symptoms were more serious in myopic students (81.8% vs. 25.2%, χ 2 = 5.811, P = 0.016). Moreover, myopia prevalence significantly differences among different exposure natural light level (χ 2 = 8.382, P = 0.039). Binary logistic regression analysis showed children who spent more time on online-study or had higher grade level had a higher risk of myopia (OR: 1.147, 95% CI: 1.044-1.259; OR: 1.147, 95% CI: 1.044-1.259). Conclusions: The prevalence of myopia in primary school students from grade 1 to grade 6 in Guangzhou city is higher than previous study conducted in Guangzhou after the online-study during COVID-19. Myopia was significantly positively associated with higher grade, spending a less time outdoors; notably, playing with electronics had the greatest influence on the risk of myopia.

Myopia Progression Among School-Aged Children in the COVID-19 Distance-Learning Era

“…This is one of the longest durations worldwide. 3,9,[12][13][14][15][16] Moreover, we had one of the longest periods of distance learning in the world (22 months). To the best of our knowledge, our study is the first to highlight important factors, such as insufficient time spent outdoors, increased recreational screen time, and younger age, that contributed to myopia progression during the pandemic based on changes in cycloplegic refraction over a three-year period in a sample with a large age range from 6 to 14 years.…”

“…8 Particularly, online learning increases the prevalence of myopia at higher-grade levels due to the extended use of electronic devices. 9 Previous studies have not looked into the progression using cycloplegic refraction, which is crucial in children. 2,3 Our study aimed to investigate the effect of prolonged screen time on myopia progression in school-aged children during the pandemic of COVID-19.…”

Myopia Prevalence Among Students During Covid-19 Pandemic. a Systematic Review and Meta-Analysis

“…The younger the onset of myopia, the faster the progression of myopia. 6 Education the prevalence of myopia in adolescents increases with grade level. 7 Research by (Hung et al, 2020) revealed that the increased prevalence of myopia was due to high learning activities.…”