Clinical Ophthalmology (Jan 2023)

Myopia Progression Among School-Aged Children in the COVID-19 Distance-Learning Era

  • Althnayan YI,
  • Almotairi NM,
  • Alharbi MM,
  • Alamer HB,
  • Alqahtani HB,
  • Alfreihi S

Journal volume & issue
Vol. Volume 17
pp. 283 – 290

Abstract

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Yasser I Althnayan,1,2 Nawal M Almotairi,2,3 Manal M Alharbi,2,3 Hadeel B Alamer,2,4 Hanan B Alqahtani,2– 4 Shatha Alfreihi2,4,5 1Ophthalmology Division, Department of Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; 2King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia; 3Department of Optometry, College of Applied Medical Science, King Saud University, Riyadh, Riyadh Province, Saudi Arabia; 4Paediatric Ophthalmology Division, Paediatric Surgery Department, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia; 5College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaCorrespondence: Shatha Alfreihi, King Abdullah Specialist Children’s Hospital, P.O. Box 22490, Riyadh, 11426, Saudi Arabia, Tel +966-11-8011111, Fax +966-11-8011000 EXT 53273, 53320, Email [email protected]: To investigate the effect of online learning and other environmental factors on myopia progression during the Coronavirus pandemic (COVID-19).Methods: A retrospective cohort study from 2018 to 2021. Data from children aged 6– 14 were gathered during three visits: pre-pandemic, at the beginning, and during the pandemic. Demographics (hours spent on screens for educational, recreational purposes, outdoors, and type of screen), best-corrected distance visual acuity (BCDVA), uncorrected distance visual acuity (UCDVA), and cycloplegic refraction were gathered.Results: Of 150 patients, 70 [47%] were boys. The mean age was 11 (2.4) years. Participants mainly used mobile phones (62%) and had insufficient outdoor play (88%). Of the 300 eyes, 221 (74%) showed myopia progression. A significant difference in spherical equivalent (SE) was found between pre-pandemic and post-pandemic periods (− 0.29 (0.23) D vs − 0.40 (0.11) D; p =0.023). Additionally, UCDVA showed a difference between the initial and 1st follow-up visits (0.57 (0.37) vs 0.64 (0.36), p =0.001), and the first and 2nd follow-up visits (0.64 (0.36) vs 0.70 (0.36), p =0.001). Significant hazard ratio for change in SE in patients with higher age (> 9 years), (HR [95% confidence interval (CI)], 0.71 [0.51– 0.84]), greater recreational screen usage (HR [95% CI], 1.26 [1.15– 1.66]), and insufficient outdoor time (HR [95% CI], 1.45 [1.35– 1.67]).Conclusion: Myopia progression was accelerated during the COVID-19 pandemic. Younger age, prolonged screen use, and insufficient outdoor time contributed to increased myopia progression. However, the type of device used had no significant effect.Keywords: myopia, distance-learning, COVID-19, pandemic, school, children

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