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

Abstract

Background: To assess the impact of study-at-home during the COVID-19 pandemic on myopia development in Chinese schoolchildren.Methods: This historical cohort involved two groups with a total of 154 children. The exposed group was formed from 77 children aged 8 to 10 years who studied at home in the 7-month period during the COVID-19 pandemic (follow-up period: January – August 2020) and did not study at home in the 7-month period before the COVID-19 outbreak (baseline period: July 2019 – January 2020). Seventy-seven children who did not undergo study-at-home (baseline period: 7 months in 2015, follow-up period: 7 months in 2016) were included in the control group. Cycloplegic refraction, axial length and uncorrected visual acuity were measured 3 times. The questionnaire mainly focused on collecting visual habits.Results: Myopia progression was similar between the two groups in the baseline period. However, in the follow-up period the exposed group had a greater change in refraction toward myopia (−0.83 ± 0.56 D) than the control group (−0.28 ± 0.54 D; p < 0.001). In addition, the exposed group exhibited a significantly greater change in refraction toward myopia in the follow-up period (−0.83 ± 0.56 D) than in the baseline period (−0.33 ± 0.46 D; p < 0.001). Difference-in-difference analysis indicated that study-at-home accelerated the change in refraction toward myopia (t = −0.567; p < 0.001).Conclusions: During the COVID-19 pandemic study-at-home accelerated the change of refraction toward myopia in children.

Effects of remote learning during the COVID-19 lockdown on children’s visual health: a systematic review

“…Similarly, there was a significant decrease in the mean SER of hyperopic and emmetropic children from 2019 to 2020, that is, 0.66±2.03 D (2019) and 0.48±1.81 D (2020), respectively, p≤0.001 30. Finally, studies examining virtual learning during the COVID-19 lockdown as an exposure risk factor found a higher incidence of myopia in children who engaged in virtual learning (p<0.01) 22–24…”

“…Most of these examined myopia progression as the main visual outcome. Eight studies reported that myopia worsened throughout the COVID-19 lockdown in children and teenagers between 5 and 18 years old 15 17 19 21–24 27. One study reported a significant decrease in spherical equivalent refraction (SER) in children with hyperopia and emmetropia (see table 2, Glossary) 30.…”

“… 30 Finally, studies examining virtual learning during the COVID-19 lockdown as an exposure risk factor found a higher incidence of myopia in children who engaged in virtual learning (p<0.01). 22–24 …”

Multiple Factors Causing Myopia and the Possible Treatments: A Mini Review

“…Huang et al reported the protective behaviors of extending proximity working distance, pausing from near work every half hour and increased time outside the home from parents' self-reports were found to have protective effects in diminishing myopia progression around 10 years-old children in Taipei ( 7 ). Therefore, home isolation and home study during COVID-19 may exacerbate worldwide burden of myopia ( 8 ). Indeed, Choi et al reported that myopia progressed more rapidly in schoolchildren during periods of high lockdown procedures associated with COVID-19.…”

“…The novel coronavirus infections 2019 (COVID-19) has been affecting the world for 2 years as of March 2022. Natural experiments provided empirical evidence that Chinese schoolchildren who were studying at home during the COVID-19 epidemic were at higher risk of myopia progression ( 8 ).…”