COVID-19 lockdowns may negatively affect myopia progression in young children
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There may be an association between home confinement due to the COVID-19 pandemic and a myopic shift in children aged 6 to 8 years in China, according to a study.
“The prevalence of myopia increased 1.4 to 3 times in 2020 compared with the previous 5 years as a result of home confinement due to COVID‐19. The refractive status of younger children (6 to 8 years of age) may be more sensitive to environmental changes than older children,” Xuehan Qian, MD, PhD, co-author of the prospective cross-sectional study, told Healio/OSN.
School-based photoscreenings were used to measure spherical equivalent refraction in 123,535 children aged 6 to 13 years from 10 elementary schools in Feicheng, China, from 2015 to 2020. The analysis included data from 194,904 test results from 389,808 eyes.
A substantial myopic shift occurred in the 2020 photoscreenings compared with the previous years for children aged 6, 7 and 8 years, with decreases in spherical equivalent refraction of –0.32 D, –0.28 D and –0.29 D, respectively. In the 2020 screenings, myopia prevalence was higher than the highest prevalence in previous years in children aged 6 years, at 21.5% vs. 5.7%; children aged 7 years, at 26.2% vs. 16.2%; and children aged 8 years, at 37.2% vs. 27.7%.
In children aged 9 to 13 years, the differences in spherical equivalent refraction and prevalence of myopia were minimal.
Screenings took place annually in September from 2015 to 2019. After schools reopened in June 2020, after a 5-month closure because of the pandemic, screenings were conducted again, with data analysis occurring in July 2020.
Perspective
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Parents around the globe are concerned that increased amount of screen time and decreased time spent outdoors imposed by the COVID-19 pandemic may lead to greater degrees of myopia in their children. In a cross-sectional study of 123,535 Chinese children, Wang and colleagues found a 1.4 to 3 times increase in the prevalence of myopia in children in 2020 compared with the previous 5 years. While all children experienced 6 months of near-constant home confinement, the children aged 6 to 8 years demonstrated the greatest increase in the prevalence of myopia. While additional prospective studies will be required to determine incidence and causation of this increased prevalence of myopia, parents and educators should balance the educational needs of these youngest children with the goal of encouraging outdoor physical activity and only essential screen time as universal vaccination allows a return back into the classroom.
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Wang J, et al. JAMA Ophthalmol. 2021;doi:10.1001/jamaophthalmol.2020.6239.
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