Myopia Progression and Influencing Factors Analysis of Schoolchildren in Wuhan After COVID-19 Home Confinement

ABSTRACT

OBJECTIVE: To investigate the effect of study and life patterns on the visual acuity of primary and secondary school students in Wuhan, China, during the COVID-19 pandemic. STUDY DESIGN: We investigated factors influencing the development of myopia using questionnaires presented to students in primary and secondary schools in Wuhan. After school resumed in September 2020, we obtained 15,596 valid questionnaires. Students who submitted valid questionnaires were examined for visual acuity and computerized optometry, from which 15,428 valid examination results were obtained. Then we cornpared these results with the screening data collected during the same period the previous year (September 2019). RESULTS: The overall prevalence of myopia among primary and secondary school students in Wuhan in 2020 was 59.95%, representing a 6.02% increase as compared with levels in 2019. For primary, junior, and senior high school students, this increase was 9.76%, 5.30%, and 2.79%, respectively. Primary school students primarily exhibited an increase in mild myopia (7.49%), while junior and senior high school students presented with increased rates of moderate (4.51%;5.74%) and high (1.17%;2.95%) myopia. Compared with 2019, senior high school students exhibited the most pronounced deepening of spherical equivalent, which deepened by -0.639 D, -0.774 D, and -0.775 D from Grade 1-3. In 2020 the students in Wuhan spent <1 hour on outdoor activities, but primary, junior, and senior high school students were engaged with online courses for 3.184 hours, 5.828 hours, and 6.239 hours and electronic products outside of online learning for 1.502 hours, 1.788 hours, and 2.146 hours, respectively. Multivariate logistic regression analysis showed that being female, high grade, long time of near-work, long time of using electronic product, the students' age of using electronic products for the first time was <= 3 years old, parents' myopia, and high education level were risk factors for myopia, while outdoor activity was a protective factor for myopia. CONCLUSION: During COVID-19, home-based online learning mode significantly increased the prevalence of myopia among students in Wuhan. The occurrence of myopia is related to heredity and eye use behavior. Increasing outdoor activities and reducing near-work time are important measures to prevent and control myopia occurrence.