Evaluating the impact of COVID-19 pandemic-related home confinement on the refractive error of school-aged children in Germany: a cross-sectional study based on data from 414 eye care professional centres

Abstract

Objective This study aimed at evaluating refractive changes in German school-aged children before and after the COVID-19 pandemic.Design Cross-sectional study.Setting 414 eye care professional centres from Germany.Participants Refractive data from 59 926 German children aged 6–15 years were examined over a 7-year period (2015–2021).Primary and secondary outcome measures Spherical equivalent refraction was assessed as a function of year, age and gender. The refractive values concerning 2020 and 2021 were compared with those assigned to prior years (2015–2019).Results The refractive data associated with 2020 and 2021 showed a myopic refractive shift of approximately −0.20D compared with the 2015–2019 range. The refractive change was statistically considerable in the 6 to 11-year range (p<0.05), while from 12 to 15 years was negligible (p≥0.10). Percentage of myopes was also impacted in 2021 (p=0.002), but not in 2020 (p=0.25). From 6 to 11 years, the percentage of myopes in 2021 increased significantly by 6.02% compared with the 2015–2019 range (p≤0.04). The highest percentage increase occurred at 8 and 10 years of age, showing a rise of 7.42% (p=0.002) and 6.62% (p=0.005), respectively. From 12 to 15 years, there was no significant increase in the percentage of myopes in 2021 (p≥0.09). Percentage of myopes in 2020 was not influenced at any age (p≥0.06).Conclusion Disruption of normal lifestyle due to pandemic-related home confinement appears to lead to a myopic refractive shift in children aged 6–11 years in Germany. The greater effect observed at younger ages seems to emphasise the importance of refractive development in this age group.