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  • COVID’s Impact on Myopia in Children

    By Jean Shaw
    Selected and Reviewed By: Neil M. Bressler, MD, and Deputy Editors

    Journal Highlights

    JAMA Ophthalmology, March 2021

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    With COVID lockdowns closing schools and keeping children confined at home, what impact is the pandemic having on the prevalence of myopia? Wang et al. set out to investigate this issue in school-age children during the early months of the COVID pandemic in China. They found that home confine­ment and the shift to online learning appeared to be linked to an increase in myopia in 6- to 8-year-old children.

    For this prospective cross-sectional study, the researchers evaluated data from a series of photoscreenings conducted at 10 elementary schools in Feicheng, China. From 2015-2019, the screenings occurred in September; in 2020, the screenings occurred in June, after schools reopened following the COVID lockdown. All told, noncycloplegic photorefractive data were avail­able from 194,904 tests conducted in 123,535 children aged 6 to 13 years.

    From 2015-2019, the spherical equivalent refraction (SER) distribu­tion in the children appeared to be stable, with a slight overall myopic shift. In the 2020 screening, however, a myopic shift of approximately –0.3 D was noted in the younger children (ages 6-8). In contrast, the SER differences between 2020 and the previous screen­ings were minimal for older children, ranging from –0.12 for 9-year-olds to –0.05 for 12- and 13-year-olds—despite the fact that the older children spent more time online in their classes (2.5 hours online per day for grades 3-6, versus 1 hour per day for grades 1-2).

    The researchers hypothesize that the refractive status of younger children may be more sensitive to environmen­tal changes that trigger myopia devel­opment, and they call for additional studies to assess the issue. In the inter­im, they wrote, “If home confinement is necessary, parents should control the children’s screen time as much as possi­ble and increase the allowable outdoor activity while maintaining safe social distancing.” (Also see related commen­tary by Caroline C.W. Klaver, MD, PhD, Jan Roelof Polling, BSc, and Clair A. Enthoven, MSc, in the same issue.)

    The original article can be found here.