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3.
Indian J Ophthalmol ; 70(8): 3040-3044, 2022 08.
Article in English | MEDLINE | ID: covidwho-2055701

ABSTRACT

Purpose: Novel coronavirus has brought huge changes in lifestyle, especially among children. Reports indicate that the prevalence of refractive errors among children has increased due to home confinement. Hence, this study was done to understand the current status of refractive errors among children from public schools in southern India. Methods: This cross-sectional study was conducted as part of school eye screening conducted between September and October 2021. Children between 14 and 17 years of age from public schools underwent a three-phased comprehensive eye examination. Children identified with refractive errors and an equal proportion of children without any refractive errors underwent a survey on outdoor activities. Prevalence estimates and 95% confidence interval were calculated. Chi-square tests and regression analysis were used to understand the association between refractive error and other variables. Results: From the data of 3,850 (90.69%) children, the prevalence of vision impairment, refractive errors, and myopia in at least one eye was found to be 12.83% (n = 494), 21.51% (n = 828), and 19.53% (n = 752), respectively. The average myopic spherical equivalent error was found to be -2.17 ± 1.11D (range:-0.50 D to -14.00 D). Almost 96.82% of girls had less than 3 h of outdoor activities. Refractive errors were 7.42 and 2.77 times more (95% CI: 3.51-15.70), P < 0.001) among children who had outdoor activities less than 3 h per day and sleep less than 7 h per day. Conclusion: Comparing to previous studies from North Indian and South Indian public schools, this study reports a three- to six-fold rise in myopia post-home confinement among public school children from India.


Subject(s)
COVID-19 , Myopia , Refractive Errors , COVID-19/epidemiology , Child , Cross-Sectional Studies , Female , Humans , India/epidemiology , Myopia/epidemiology , Prevalence , Refractive Errors/epidemiology
4.
Asia Pac J Ophthalmol (Phila) ; 11(5): 470-480, 2022 Sep 01.
Article in English | MEDLINE | ID: covidwho-2051584

ABSTRACT

PURPOSE: To conduct a systematic review and meta-analysis to assess the effects of coronavirus disease 2019 (COVID-19) pandemic-related lifestyle on myopia outcomes in children to young adults. METHODS: A systematic search was conducted on PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases (with manual searching of reference lists of reviews). Studies included assessed changes in myopia-related outcomes (cycloplegic refraction) during COVID and pre-COVID. Of 367 articles identified, 7 (6 prospective cohorts; 1 repeated cross-sectional study) comprising 6327 participants aged 6 to 17 were included. Quality appraisals were performed with Joanna Briggs Institute Critical Appraisal Checklists. Pooled differences in annualized myopic shifts or mean spherical equivalent (SE) during COVID and pre-COVID were obtained from random-effects models. RESULTS: In all 7 studies, SE moved toward a myopic direction during COVID (vs pre-COVID), where 5 reported significantly faster myopic shifts [difference in means of changes: -1.20 to -0.35 diopters per year, [D/y]; pooled estimate: -0.73 D/y; 95% confidence interval (CI): -0.96, -0.50; P<0.001], and 2 reported significantly more myopic SE (difference in means: -0.72 to -0.44 D/y; pooled estimate: -0.54 D/y; 95% CI: -0.80, -0.28; P<0.001). Three studies reported higher myopia (SE ≤-0.50 D) incidence (2.0- to 2.6-fold increase) during COVID versus pre-COVID. Of studies assessing lifestyle changes, all 4 reported lower time outdoors (pre-COVID vs during COVID: 1.1-1.8 vs 0.4-1.0 hours per day, [h/d]), and 3 reported higher screen time (pre-COVID vs during COVID: 0.7-2.8 vs 2.4-6.9 h/d). CONCLUSIONS: This review suggests more myopic SE shifts during COVID (vs pre-COVID) in participants aged 6 to 17. COVID-19 restrictions may have worsened SE shifts, and lifting of restrictions may lessen this effect. Evaluations of the long-term effects of the pandemic lifestyle on myopia onset and progression in large studies are warranted to confirm these findings.


Subject(s)
COVID-19 , Myopia , COVID-19/epidemiology , Child , Cross-Sectional Studies , Disease Progression , Humans , Life Style , Mydriatics , Myopia/epidemiology , Pandemics , Prospective Studies , Refraction, Ocular , Young Adult
5.
Front Public Health ; 10: 835449, 2022.
Article in English | MEDLINE | ID: covidwho-1987559

ABSTRACT

Background: The COVID-19 pandemic has made many countries adopt restrictive measures like home quarantine. Children were required to study at home, which made parents worried about the rapid myopic progression of their children. To compare myopia progression during the COVID-19 pandemic home quarantine with the time before it and risk factors of myopia progression, we conducted this study. Methods: We searched PubMed, Embase, the Cochrane Library, and Web of Science to find literature from December 2019 to March 2022 related to COVID-19 pandemic home quarantine and children's myopia progression. Outcomes of myopia progression included axial length and spherical equivalent refraction. Factors of digital screen device time and outdoor activity time were analyzed. Results: Ten studies were included in this meta-analysis. Compared to the same period before the COVID-19 pandemic, spherical equivalent refraction decreased (OR = -0.27; 95% CI = [-0.33, -0.21]; Z = 8.42; P < 0.00001). However, the subgroup analysis showed that there were no significant differences in spherical equivalent refraction between the two groups in higher-grade school-aged children (grades 4 and above, 11 to 18 years old) (OR = 0.01; 95% CI = [-0.05, 0.07]; Z =0.4; P = 0.69). The outcome of axial length showed no significant difference (OR = 0.06; 95% CI = [-0.31, 0.44]; Z = 0.34; P = 0.74). As for risk factors, the forest plots showed that digital screen device time (OR = 4.56; 95% CI = [4.45, 4.66]; Z = 85.57; P < 0.00001) and outdoor activity time (OR = -1.82; 95% CI = [-2.87, -0.76]; Z = 3.37; P = 0.0008) were risk factors of myopia progression. Conclusion: Compared with the time before the COVID-19 pandemic, myopia progression in children during COVID-19 pandemic home quarantine was accelerated, especially in younger children. Increased digital screen device and decreased outdoor activity times were risk factors. When home quarantine eases, more time on outdoor activities and less time on digital screen devices are needed for children. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/logout.php.


Subject(s)
COVID-19 , Myopia , Adolescent , COVID-19/epidemiology , COVID-19/prevention & control , Child , Humans , Myopia/epidemiology , Pandemics , Quarantine , Refraction, Ocular
6.
Adv Ther ; 39(6): 2999-3010, 2022 06.
Article in English | MEDLINE | ID: covidwho-1959164

ABSTRACT

INTRODUCTION: To investigate changes in refractive error in schoolchildren before and during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This study included 2792 students, who underwent a 3-year follow-up from 2018 to 2020. All participants underwent yearly noncycloplegic refraction and ocular examinations. Time-related changes in sphere, cylinder, and spherical equivalent (SE) measurements in both genders were analyzed. RESULTS: The myopic sphere (- 0.78 ± 1.83 vs. - 1.03 ± 1.91 D; P = 0.025) and SE (- 1.04 ± 1.90 vs. - 1.32 ± 1.99 D; P = 0.015) progressed significantly from 2018 to 2019. Female participants had a significantly greater change in SE than male participants (P < 0.05), and the low hyperopia, emmetropia, and mild myopia groups significantly deteriorated (P < 0.001) from 2018 to 2019. Significant differences in sphere change (- 0.21 ± 0.97 vs. - 0.36 ± 0.96 D; P < 0.001) and SE change (- 0.23 ± 0.99 vs. - 0.38 ± 0.98 D; P < 0.001) were noted between 2019-2018 and 2020-2019, respectively. The respective changes in cylinder were statistically similar (- 0.03 ± 0.53 vs. - 0.05 ± 0.62 D; P = 0.400). CONCLUSIONS: The refractive status of schoolchildren showed an increasing myopic shift trend before and during the COVID-19 pandemic. The low hyperopia, emmetropia, and mild myopia groups were more sensitive to environmental changes during COVID-19 than before. The myopic shift was greater in female participants than male participants.


Subject(s)
COVID-19 , Hyperopia , Myopia , Refractive Errors , Child , Female , Follow-Up Studies , Humans , Hyperopia/epidemiology , Male , Myopia/epidemiology , Pandemics , Refractive Errors/epidemiology
7.
Ophthalmic Physiol Opt ; 42(6): 1227-1231, 2022 11.
Article in English | MEDLINE | ID: covidwho-1956789

ABSTRACT

PURPOSE: This study compared refractive and axial length (AL) changes in children wearing dual-focus soft contact lenses for myopia control (MiSight®) with myopic children wearing spectacles one year from the start of lockdown during the COVID-19 pandemic. METHODS: This retrospective, descriptive, parallel-group, observational study reviewed the charts of 11 children who began treatment for myopia control with dual-focus soft contact lenses for myopia control (MiSight®) in March 2020 and 11 matched spectacle-wearing controls. The mean increase in spherical equivalent refraction (SER) and AL from the beginning of the lockdown and up to 1 year later were compared. The parents of the children were asked about the average time spent on near work, contact lens wearing time both during and after the strict confinement and whether they had discontinued contact lens wear during lockdown. RESULTS: During this first year of preventive COVID-19 measures (March 2020-March 2021), for the contact lens group the average SER and AL increased -0.14 ± 0.09D and 0.13 ± 0.05 mm, respectively. For the spectacle wearers, the corresponding increases were -0.54 ± 0.16D and 0.25 ± 0.08 mm, respectively. A significant difference was found between the groups for both SER (p < 0.001) and AL (p < 0.05). The average time spent outdoors was restricted for both groups during lockdown and increased after. However, statistically significant changes in the time spent outdoors during and after lockdown were only found for the spectacle group (p < 0.05; t-test), whereas this change was not significant for the contact lens group (p = 0.08). CONCLUSIONS: Over the observed time period, dual-focus soft contact lenses for myopia control were effective despite the decreased time spent outdoors during the COVID-19 pandemic.


Subject(s)
COVID-19 , Contact Lenses, Hydrophilic , Myopia , COVID-19/epidemiology , COVID-19/prevention & control , Child , Communicable Disease Control , Humans , Myopia/epidemiology , Myopia/therapy , Pandemics/prevention & control , Refraction, Ocular , Retrospective Studies
8.
Front Public Health ; 10: 897600, 2022.
Article in English | MEDLINE | ID: covidwho-1952857

ABSTRACT

The myopia epidemic has become a global public health problem. Although myopia is progressing worldwide, the recent coronavirus infections 2019 (COVID-19) outbreak has spurred myopia progression. The current evidence-based treatments for humans are atropine eye drops, optical treatment with defocus, use of orthokeratology, extending proximity working distance, pausing from near work every half hour and increased time outside the home. Studies on myopia using animal models have been conducted for more than 40 years. In recent years, new mechanisms of myopia suppression have been revealed from animal experiments such as inflammation control, intraocular pressure control, light control, and the activity of early growth response protein 1 control. This mini-review provides a summary of the scientific evidence currently available on the control of myopia, and the possible treatments mitigating myopia.


Subject(s)
COVID-19 , Myopia , Atropine/therapeutic use , Disease Progression , Humans , Myopia/epidemiology , Myopia/therapy , Ophthalmic Solutions
9.
Front Public Health ; 10: 918182, 2022.
Article in English | MEDLINE | ID: covidwho-1938654

ABSTRACT

Purpose: To review the association between children's behavioral changes during the restriction due to the pandemic of Coronavirus disease (COVID-19) and the development and progression of myopia. Design: A literature review. Method: We looked for relevant studies related to 1) children's behavioral changes from COVID-19 restriction and 2) children's myopia progression during COVID-19 restriction by using the following keywords. They were "Behavior," "Activity," "COVID-19," "Lockdown," "Restriction," and "Children" for the former; "Myopia," "COVID-19," "Lockdown," "Restriction" for the latter. Titles, abstracts and full texts from the retrieved studies were screened and all relevant data were summarized, analyzed, and discussed. Results: Children were less active and more sedentary during COVID-19 restriction. According to five studies from China and six studies, each from Hong Kong, Spain, Israel, South Korea, Turkey and Taiwan included in our review, all countries without myopia preventive intervention supported the association between the lockdown and myopia progression by means of negative SER change ranging from 0.05-0.6 D, more negative SER change (compared post- to pre-lockdown) ranging from 0.71-0.98 D and more negative rate of SER changes (compared post- to pre-lockdown) ranging from 0.05-0.1 D/month. The reported factor that accelerated myopia is an increase in total near work, while increased outdoor activity is a protective factor against myopia progression. Conclusion: The pandemic of COVID-19 provided an unwanted opportunity to assess the effect of the behavioral changes and myopia in the real world. There is sufficient evidence to support the association between an increase in near work from home confinement or a reduction of outdoor activities and worsening of myopia during the COVID-19 lockdown. The findings from this review of data from the real world may help better understanding of myopia development and progression, which may lead to adjustment of behaviors to prevent myopia and its progression in the future.


Subject(s)
COVID-19 , Myopia , COVID-19/epidemiology , Communicable Disease Control , Humans , Myopia/epidemiology , Pandemics/prevention & control , Social Factors
10.
Front Public Health ; 10: 890261, 2022.
Article in English | MEDLINE | ID: covidwho-1903231

ABSTRACT

Purpose: To report the design and baseline data of a 3-year cohort study in Beijing Pinggu District primary school students in China after COVID-19. Methods: Noncycloplegic and cycloplegic spherical equivalent refraction (SER) were measured, ocular biometry, including the axial length (AL), anterior chamber depth (ACD) and corneal power (CP), were collected before cycloplegia. Corneal radius (CR), AL-to-CR ratio, and lens power (LP) were calculated. Results: Among the 4,806 (89.1%) eligible students (51.5% male), the prevalence of emmetropia, myopia, mild hyperopia, and mild-to-high hyperopia was 12.8, 30.8, 53.0, and 3.3% after cycloplegia, respectively. Myopia increased from 2.5% in 6- to 71.6% in 12-year-old students, with 9- and 10-year-olds showing the most prominent increases. The median of cycloplegic SER was 0.50 (IQR = 1.63), and the noncycloplegic SER was -0.38 D (IQR = 1.50), which is more negative than the cycloplegic refraction. The mean AL increased with age, from 22.46 ± 0.70 mm to 24.26 ± 1.07 mm. The ACD increased from 3.38 ± 0.28 mm to 3.70 ± 0.30 mm, and the AL-to-CR ratio increased from 2.91 ± 0.08 to 3.12 ± 0.13 between 6- and 12-year-old students. AL, CR and LP explained the SER variance with R 2 of 86.4% after adjusting the age and gender. Conclusions and Relevance: The myopia prevalence since emergence of COVID-19 rapidly increased from 6- to 12-year primary school Chinese children, especially after 7 years of age. The non-cycloplegia SER overestimated the prevalence of myopia, and the cycloplegic SER is a more accurate and reliable method to assess the prevalence of refractive status.


Subject(s)
COVID-19 , Hyperopia , Myopia , Beijing/epidemiology , COVID-19/epidemiology , Child , China/epidemiology , Cohort Studies , Female , Humans , Hyperopia/epidemiology , Male , Mydriatics , Myopia/epidemiology , Schools , Students
11.
Semin Ophthalmol ; 37(6): 756-766, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1886298

ABSTRACT

PURPOSE: To investigate the prevalence of myopia and the risk factors associated with its progression in elementary school students during the COVID-19 pandemic in Shanxi Province, China. METHODS: The investigation included 960 students spanning first to sixth grade from six elementary schools in Shanxi Province, China. All participants received non-cycloplegic refraction and vision tests in December of 2019 (before the COVID-19 pandemic) and in June of 2020 (after classes resumed). Information concerning the students' eye-use behaviors, physical activities, diet and sleep during the pandemic was collected using a questionnaire survey. A total of 913 students (457 males) completed all tests and the questionnaire. RESULTS: The overall prevalence rate of myopia was 16.6% in December of 2019, and it increased with age. There was no gender difference in the prevalence of myopia (χ2 = 3.210, P = .073), but females exhibited a lower average spherical equivalent (SE) (P = .026). When the classes were resumed 6 months later, the overall prevalence rate of myopia was found to be 39.4%, which was significantly higher than it before the pandemic (χ2 = 117.425, P < .001). The average SE of the participants was -0.95D, which was significantly lower than the average SE (-0.43D) before the pandemic (P < .001). SE variation (ΔSE) in grade 6 was significantly higher than that in grade 1. No significant difference in ΔSE was found between males and females. Analyses of ordinary least squares (OLS)-estimated linear, natural logarithmic and quadratic functions revealed that the progression of myopia during the COVID-19 pandemic was significantly correlated with screen time, types of electronic devices, the amount of sleep, age, and the number of parents with myopia. CONCLUSIONS: The prevalence rate and progression of myopia among elementary school students in Shanxi Province increased significantly during the COVID-19 pandemic, which was likely related to China's home-based online learning programs. Therefore, it is necessary to optimize the educational programs for elementary school students when they study at home. We recommend increased time for outdoor activities and limiting screen time.


Subject(s)
COVID-19 , Myopia , COVID-19/epidemiology , China/epidemiology , Female , Humans , Male , Myopia/epidemiology , Pandemics , Prevalence , Refraction, Ocular , Students
12.
Front Public Health ; 10: 859285, 2022.
Article in English | MEDLINE | ID: covidwho-1785455

ABSTRACT

Objectives: To evaluate myopia development among primary and secondary school students during the coronavirus 2019 (COVID-19) pandemic. Methods: A cross-sectional study was conducted to evaluate the development of myopia among students in Shenzhen, China during the COVID-19 outbreak. Results: The study included 1,472,957 and 1,573,824 students in 2019 and 2020, respectively. The prevalence of myopia was 46.9 and 50.5% in 2019 and 2020, respectively. The prevalence of myopia among students in the former Shenzhen Special Economic Zone (SEZ) was higher than that in areas outside the former Shenzhen SEZ (2019: 47.0 vs. 43.7%; 2020: 50.5 vs. 47.3%). The prevalence of myopia among girls was higher than that among boys (2019: 50.4 vs. 44.0%; 2020: 54.0 vs. 47.6%). The 50th percentile (P 50) of spherical equivalent refraction (SER) in the right eye among girls was lower than that in boys. The prevalence of myopia continued to increase as the grade increased, with the greatest annual increase observed in Grades 2-5 (3.4-3.9%). The P 50 of SER in the right eye of students decreased as the grade increased. Conclusions: The prevalence of myopia among students increased during the COVID-19 pandemic, especially in primary school Grades 2-5.


Subject(s)
COVID-19 , Myopia , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Myopia/epidemiology , Pandemics , Schools , Students
13.
Front Public Health ; 10: 846601, 2022.
Article in English | MEDLINE | ID: covidwho-1776057

ABSTRACT

Background: Myopia is one of the most common causes of vision impairment in children and adults and has become a public health priority with its growing prevalence worldwide. This study aims to identify and evaluate the global trends in myopia research of the past century and visualize the frontiers using bibliometric analysis. Methods: The literature search was conducted on the Web of Science for myopia studies published between 1900 and 2020. Retrieved publications were analyzed in-depth by the annual publication number, prolific countries and institutions, core author and journal, and the number of citations through descriptive statistics. Collaboration networks and keywords burst were visualized by VOSviewer and CiteSpace. Myopia citation network was visualized using CitNetExplorer. Results: In total, 11,172 publications on myopia were retrieved from 1900 to 2020, with most published by the United States. Saw SM, from the National University of Singapore, contributed the most publications and citations. Investigative Ophthalmology & Visual Science was the journal with highest number of citations. Journal of Cataract and Refractive Surgery with the maximum number of publications. The top 10 cited papers mainly focused on the epidemiology of myopia. Previous research emphasized myopia-associated experimental animal models, while recent keywords include "SMILE" and "myopia control" with the stronger burst, indicating a shift of concern from etiology to therapy and coincided with the global increment of incidence. Document citation network was clustered into six groups: "prevalence and risk factors of myopia," "surgical control of myopia," "pathogenesis of myopia," "optical interventions of myopia," "myopia and glaucoma," and "pathological myopia." Conclusions: Bibliometrics analysis in this study could help scholars comprehend global trends of myopia research frontiers better. Hundred years of myopia research were clustered into six groups, among which "prevalence and risk factors of myopia" and "surgical control of myopia" were the largest groups. With the increasing prevalence of myopia, interventions of myopia control are a potential research hotspot and pressing public health issue.


Subject(s)
Biomedical Research , Myopia , Bibliometrics , Biomedical Research/trends , Humans , Myopia/epidemiology , Public Health
14.
Ophthalmology ; 129(8): 880-889, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1763922

ABSTRACT

PURPOSE: Premyopia at a young age carries a great risk of developing early-onset myopia, especially in regions with myopia epidemics, such as the developed areas in East Asia. This study aims to report the prevalence of premyopia and its risk factors in a Taiwan preschool population and lifestyle changes among premyopic preschoolers before and during the Coronavirus Disease 2019 (COVID-19) pandemic. DESIGN: Repeated countywide population-based, cross-sectional study in Yilan County, northeastern Taiwan. PARTICIPANTS: From 2014 to 2020, a total of 23 930 kindergarteners aged 5 to 6 years were identified in the Yilan Myopia Prevention and Vision Improvement Program (YMVIP). Of those, 21 761 (11 335 [52.1%] boys; mean age, 5.15 ± 0.37 years) were included for final analysis. METHODS: Annual kindergarten-based eye examinations and myopia prevention strategies have been conducted since the commencement of the YMVIP in 2014. Refractive error was determined by cycloplegic autorefraction. The data of potential risk factors for myopia were gathered by caregiver-administered questionnaires. MAIN OUTCOME MEASURES: The prevalence of premyopia (spherical equivalent [SE] > -0.5 diopter [D] and ≤ +0.75 D in the eye with less SE value). RESULTS: The prevalence of myopia (SE ≤ -0.5 D), premyopia, and hyperopia (SE > +0.75) was 10.7% (95% confidence interval [CI], 10.3-11.1), 52.0% (95% CI, 51.3-52.7), and 37.3% (95% CI, 36.7-37.9), respectively. Multinomial logistic regression analysis showed that premyopia prevalence was significantly associated with male gender (odds ratio [OR], 1.25; 95% CI, 1.18-1.32), caregiver myopia (OR, 1.46; 95% CI, 1.37-1.56), screen time ≥ 1 hour per weekdays (OR, 1.10; 95% CI, 1.04-1.17), 2-year exposure to myopia prevention strategy (OR, 0.59; 95% CI, 0.54-0.65), and college or higher education level of caregiver (OR, 0.91; 95% CI, 0.85-0.96). Even without large-scale school closure in Taiwan, there was a slight upward trend of increased time spent on screen-based devices during the COVID-19 pandemic. CONCLUSIONS: Our findings showed that premyopia was the most common refractive error in a Taiwan preschool population. Premyopia was also associated with both parental and environmental myopiogenic factors. Longitudinal studies are warranted to examine the lifestyle change and myopic shift of premyopic preschoolers in the postpandemic era.


Subject(s)
COVID-19 , Myopia , Refractive Errors , COVID-19/epidemiology , Child, Preschool , Cross-Sectional Studies , Female , Humans , Male , Myopia/epidemiology , Pandemics , Prevalence , Refraction, Ocular , Refractive Errors/epidemiology , Risk Factors , Schools , Surveys and Questionnaires , Taiwan/epidemiology
15.
PLoS One ; 17(3): e0262166, 2022.
Article in English | MEDLINE | ID: covidwho-1753183

ABSTRACT

PURPOSE: The aim of this study was to investigate the change of myopic prevalence in students with different demographic characteristics before and after the COVID-19 pandemic in Suqian, China. METHODS: A retrospective, cross-sectional study was conducted. Student data from 52 schools in 2019 and 2020 were collected from the electronic medical records database through cluster sampling. Ophthalmic examinations were conducted on students from September to December in 2019 and 2020. Measurements of uncorrected visual acuity (UCVA) and noncycloplegic autorefraction were included to obtain the spherical equivalent refraction (SER) and prevalence of myopia. The difference in the rate of myopia and SER of students ages 6 to 18 with various demographic characteristics was compared between the two years. RESULTS: Records from 118,479 students in 2019 and the 121,881 students in 2020 were obtained. In 2019 and 2020, the prevalence of overall myopia increased from 43.1% to 48.9% (5.8 percentage point), and a substantial shift in myopic rate occurred in grades 4 to 6 (6.9 percentage point). The change in the prevalence of myopia in girls (5.9 percentage point) was approximately equal to that in boys (5.8 percentage point) and it was more common in rural students (5.9 percentage point) than in urban students (5.1 percentage point). The prevalence of low myopia increased more in children, and the prevalence of moderate myopia increased more in adolescents. The mean spherical equivalent refraction (SER) (-1.34±2.03 D) was lower in 2020 than in 2019 (-1.16±1.92 D), while SER decreased mainly at ages 7 to 15. The SER presented myopic status at the age of 9 (-0.55±1.26 D in 2019, -0.71±1.42 D in 2020), and attained moderate myopia at the age of 15 (-3.06±2.41 D in 2019, -3.22±2.40 D in 2020). CONCLUSIONS: After the COVID-19 pandemic, myopia increased in this population with variable rates of increase in different demographic groups. The change of myopia in children was comparatively greater than that in adolescents. Therefore, we should take measures to prevent and control the development of myopia after the COVID-19 pandemic, especially for younger students.


Subject(s)
COVID-19/epidemiology , Myopia/epidemiology , Refractive Errors/epidemiology , Rural Health/statistics & numerical data , Rural Population/statistics & numerical data , Adolescent , Child , China/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Prevalence , Retrospective Studies , Visual Acuity
16.
Ophthalmic Physiol Opt ; 42(4): 744-752, 2022 07.
Article in English | MEDLINE | ID: covidwho-1752722

ABSTRACT

PURPOSE: Although studies have suggested that the coronavirus disease 2019 (COVID-19) outbreak increased myopia progression, they had different settings and analysis methods. This study compared myopia progression before and during the COVID-19 outbreak using meta-analysis. METHODS: Relevant literature was searched on EMBASE, PubMed, ClinEpiDB and Web of Science and reviewed until 8 October 2021. The Newcastle-Ottawa Scale was used to evaluate the quality of the original studies. The mean difference of change in spherical equivalent refraction (SER) was used for evaluation before and during the COVID-19 pandemic. RESULTS: The meta-analysis included eight studies with 773, 797 individuals aged 5-18 years. Pooled analysis indicated that the mean difference of annual myopia progression during the pandemic was 0.41 D higher (95% confidence interval [CI]: 0.35-0.48, p < 0.01) than before the pandemic. Subgroup analysis using cycloplegic (mean difference, 0.30 D; 95% CI, 0.22-0.38; p < 0.01) or noncycloplegic refraction (mean difference, 0.60 D; 95% CI, 0.27-0.93; p < 0.01) indicated that the mean difference of annual myopia progression during COVID-19 significantly increased in both refractive measurements. CONCLUSION: Our findings demonstrated that the COVID-19 pandemic accelerated myopic progression compared to the past. Government policies are urgently required to prevent and control myopia progression.


Subject(s)
COVID-19 , Myopia , Adolescent , COVID-19/epidemiology , Child , Disease Progression , Humans , Myopia/epidemiology , Pandemics , Public Health , Refraction, Ocular
17.
J AAPOS ; 26(2): 65.e1-65.e4, 2022 04.
Article in English | MEDLINE | ID: covidwho-1747871

ABSTRACT

PURPOSE: To determine whether the myopic shift at myopia onset was faster than usual during home confinement associated with the COVID-19 pandemic. METHODS: Data on refractive error in consecutive children who presented for their first myopic spectacle prescription from September 2020 to May 2021 (new-onset myopia during the pandemic) were collected. Inclusion criteria were age 5-18 years and cycloplegic spherical equivalent in both eyes in the emmetropic range in the pre-pandemic years as recorded 1 year and 2 years before the actual visit. Annualized mean myopic shifts over the two previous periods were calculated. RESULTS: A total of 39 subjects (59% girls) were enrolled. Mean age at the visit after confinement was 10.79 ± 2.83 years. The mean refractive error for the right eyes in 2018 was +0.29 ± 0.56 D. The year after (2019), these children had a mean spherical equivalent of -0.12 ± 0.70 D. At the enrollment visit after myopia onset in the pandemic period, they had myopia of -1.33 ± 0.73 D. The mean annualized myopic shift for the right eyes was -0.37 ± 0.43 D before the pandemic and -1.12 ± 0.70 D during the pandemic period that included home confinement (P < 0·001 [Wilcoxon text]). CONCLUSIONS: Previous pre-pandemic prospective studies have reported myopic shift at onset of approximately -0.80 D. The period of strict pandemic home confinement saw higher rates of myopic shift.


Subject(s)
COVID-19 , Myopia , Refractive Errors , COVID-19/epidemiology , Child , Disease Progression , Female , Humans , Infant , Male , Myopia/diagnosis , Myopia/epidemiology , Pandemics , Prospective Studies , Refraction, Ocular , Refractive Errors/epidemiology
18.
Ophthalmic Res ; 65(3): 321-327, 2022.
Article in English | MEDLINE | ID: covidwho-1691198

ABSTRACT

INTRODUCTION: Uncorrected refractive error is one of the major causes of visual impairment in children and adolescents worldwide. During the COVID-19 epidemic, home isolation is considered a boost to the progression of children's myopia. Under geographical conditions of high altitude and strong sunshine, the Tibetan plateau is the main residence of the Tibetan population, where little information is available about the refractive status and developmental trajectory. Therefore, this article aimed to evaluate the distribution, progression, and associated factors of the refractive status in second-grade children in Lhasa after COVID-19 quarantine. MATERIALS AND METHODS: Students from 7 elementary schools completed comprehensive ocular examinations in the Lhasa Childhood Eye Study. Data regarding cycloplegic refraction and corneal biometry parameters, including axial length (AL), corneal power, anterior chamber depth (ACD), and other demographic factors, were analyzed. RESULTS: A total of 1,819 students were included, with a mean age of 7.9 ± 0.5 years, of which 961 were boys (52.8%), and 95.1% were Tibetan. The prevalence of myopia, emmetropia, mild hyperopia, and hyperopia was 10.94%, 24.02%, 60.80%, and 4.24%, respectively. Besides, the average cycloplegic spherical equivalent refraction (SER) was +1.07 ± 0.92 diopter (D) before the COVID-19 quarantine and +0.59 ± 1.08D after the quarantine (p < 0.05), with a growth rate of 7%. Moreover, the prevalence of hyperopia in girls was significantly higher than that of boys (p < 0.001). Nonetheless, the proportion of myopia and emmetropia was similar (p = 0.75). Meanwhile, children in suburban schools had a significantly lower proportion of myopia (p < 0.001). The average AL, ACD, lens power (LP), and AL-to-corneal radius (AL/CR) ratio were 22.79 ± 0.78 mm, 3.54 ± 0.21 mm, 25.12 ± 1.48D, and 2.93 ± 0.08, respectively. The results of AL, ACD, and AL/CR for girls were significantly lower than for boys, while the result of LP is the opposite (p < 0.001). Finally, multivariate regression analysis revealed that SER was negatively correlated with AL, LP, and AL/CR ratio, while positively correlated with CR and ACD (p < 0.001). CONCLUSION: This study found that after the COVID-19 confinement, myopia progressed faster in Lhasa children but was still significantly lower than that of plain cities in China. Compared to short-term confinement, this acceleration was more likely related to the growth and general trend of myopia in children. Collectively, these findings help to explore the differences in ocular growth and development among children of different ethnic groups.


Subject(s)
COVID-19 , Hyperopia , Myopia , Refractive Errors , Adolescent , Biometry , COVID-19/epidemiology , Child , Cornea , Female , Humans , Male , Mydriatics , Myopia/epidemiology , Quarantine , Refraction, Ocular , Tibet/epidemiology
19.
Indian J Ophthalmol ; 70(1): 241-245, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1596094

ABSTRACT

PURPOSE: This study was performed to compare the rate of progression of myopia before and during the COVID-19 pandemic and to assess the risk factors of hastened progression. METHODS: All children with myopia of spherical equivalence ≤ -0.5 D with at least two prior documented refractions 6 months and 1 year before were included. The annual progression rate before COVID-19 and during COVID-19 was calculated. Annual myopia progression was categorized as no progression (0), slow progression (<1 D), and fast progression (≥1 D). RESULTS: A total of 133 children (266 eyes) aged 6-18 years were included in the study. Mean annual myopia progression was found to be statistically significant during COVID-19 as compared with pre-COVID-19 (0.90 vs 0.25 D, P < 0.00001). A total of 45.9% of children showed an annual progression of ≥1 D during the pandemic as compared with 10.5% before the COVID-19 (p < 0.00001). In multivariate analysis, history of rapid progression in pre-COVID-19 era (P = 0.002) and sun exposure <1 h/day (P < 0.00001) were found to be independent risk factors for rapid myopia progression. CONCLUSION: Parents should consider risk of rapid myopia progression in children during current pandemic and children should be provided with socially distant outdoor activities to increase their sun exposure and diminish the rate of myopia progression.


Subject(s)
COVID-19 , Myopia , Child , Disease Progression , Humans , Myopia/diagnosis , Myopia/epidemiology , Pandemics , Refraction, Ocular , SARS-CoV-2
20.
Indian J Ophthalmol ; 70(1): 245-246, 2022 01.
Article in English | MEDLINE | ID: covidwho-1595092
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