Colombian Ocular Diseases Epidemiology Study (CODES): incidence and sociodemographic characterisation of keratoconus between 2015 and 2020.

OBJECTIVE: To estimate the incidence and describe the demographic characteristics of keratoconus (KC) in Colombia using national health registry data between January 1st 2015 and December 31th 2020. METHODS AND ANALYSIS: We conducted a nationwide, population-based study using the Integrated Social Protection Information System from the Colombian Ministry of Health, the unique official database in the country. We used the International Classification of Diseases code for KC (H186) to identify the number of new cases of KC and estimate the incidence rates both overall and according to age and sex. We made a standard morbidity ratio map to graph Colombia's morbidity risk of KC onset. RESULTS: Of 50 372 424 subjects, 21 710 had KC between 2015 and 2020. However, due to the COVID-19 pandemic, all the incidence rates of this study were based on the 18 419 reported until 2019. The incidence rate in the general population was 10.36 (95% CI 10.08 to 10.64) per 100 000 inhabitants. The incidence peak among males was in their early 20s and females in their late 20s. The overall male to female incidence rate ratio was 1.60. Regarding the distribution of the disease, most cases were reported in Bogotá (48.64%), Antioquia (14.04%) and Cundinamarca (10.38%). CONCLUSION: We performed the first nationwide, population-based study of KC in Latin America, finding distribution patterns similar to those reported in the literature. This study provides valuable information on the epidemiology of KC in Colombia, which is helpful in the development of policies for the diagnosis, prevention and treatment of the disease.

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

OBJECTIVES: Increased exposure to digital devices as part of online classes increases susceptibility to visual impairments, particularly among school students taught using e-learning strategies. This study aimed to identify the impact of remote learning during the COVID-19 lockdown on children's visual health. DESIGN: Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES: Scopus, PubMed and ScienceDirect databases from the year 2020 onwards. ELIGIBILITY CRITERIA: We included cross-sectional, case-control, cohort studies, case series and case reports, published in English, Spanish or French, that approached the effects of remote learning during the COVID-19 lockdown on visual health in neurotypical children. DATA EXTRACTION AND SYNTHESIS: We included a total of 21 articles with previous quality assessments using the Joanna Briggs checklist. Risk of bias assessment was applied using the National Institutes of Health quality assessment tool for before-and-after studies with no control group; the tool developed by Hoy et al to assess cross-sectional studies; the Murad et al tool to evaluate the methodological quality of case reports and case series; and the Newcastle-Ottawa Scale for cohort studies. RESULTS: All but one study reported a deleterious impact of the COVID-19 lockdown on visual health in children. Overall, the most frequently identified ocular effects were refractive errors, accommodation disturbances and visual symptoms such as dry eye and asthenopia. CONCLUSIONS: Increased dependence on digital devices for online classes has either induced or exacerbated visual disturbances, such as rapid progression of myopia, dry eye and visual fatigue symptoms, and vergence and accommodation disturbances, in children who engaged in remote learning during the COVID-19 lockdown. PROSPERO REGISTRATION NUMBER: CRD42022307107.