COVID-19 confinement may have caused myopia in children

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The COVID-19 pandemic may have increased the prevalence of myopia by confining young children indoors, the researchers say.

It seems that spending more time focusing on computer screens has further affected the sight of younger children in school, said Xuehan Qian, MD, PhD, of the Tianjin Medical University University Hospital in Tianjin, China.

“We should be concerned about COVID-19 eye problems, not the virus itself, but the possible outcomes of antivirus measures on visual health.”

Qian presented the finding at the 2021 annual meeting of the Virtual Association for Research in Vision and Ophthalmology (ARVO), and with his colleagues published it in JAMA Ophthalmology.

Myopia has spread around the world for decades; the World Health Organization estimates that half of the world’s population will be nearsighted by 2050.

Researchers have identified time spent indoors and the duration and intensity of nearby work as risk factors for myopia. The quality of light in these conditions appears to influence the way the eye develops, especially in children, said Jeffrey Cooper, OD, MS, professor emeritus at New York State University, School of Optometry. New York City.

Although people with myopia may see their glasses or contacts well after or after surgery, myopia increases their risk of elevating myopia later in life, which in turn can lead to retinal detachment, retinal tears, myopic macular degeneration, glaucoma and blindness, Cooper said Medscape Medical News.

When the COVID-19 pandemic hit in late January 2020, China imposed a strict closure, which shut down approximately 220 million school-age children and adolescents in their homes where they were offered online courses until that schools reopened in June.

To calculate the effect on myopia, Qian and colleagues analyzed projection data that were performed annually on children in 10 elementary schools in Shandong, China, from 2015 to 2020 using the Welch Allyn Spot Vision Screener .

It is kept 1 m away from the child, the sieve measures the equivalent spherical refraction (SER) for both eyes. The screen range is ± 7.50 diopters (D). If the refraction is out of this range, the selector marks the subject for referral for a complete eye examination.

From 2015 to 2019, screenings took place in September, but in 2020 they were made shortly after the school reopened in June.

Over the 6 years, examiners performed 194,904 tests on 123,535 children aged 6 to 13 years.

Table. Prevalence of myopia by age in years

Age 2018,% 2019,% 2020,% Pg value
6, n = 22,082

5.4

5.7

21.5

<.001

7, n = 27,979

16.2

13.6

26.2

<.001

8, n = 25.877

27.7

26.3

37.2

<.001

9, n = 23,591

43.5

38.8

45.3

.09

From 2015 to 2019, the average SER remained stable, but in 2020 it decreased sharply in younger children: 0.32 D in 6-year-olds, 0.28 D in 7-year-olds and 0.29 D in 8-year-olds . In older children, the change was smaller.

Similarly, the prevalence of myopia, defined as BE below -0.5 D, skyrocketed in 2020 for children aged 6 to 7 and 8 years, but in older children the change was not significant. .

A difference in the amount of time spent at a nearby job probably doesn’t explain the difference between younger and older children, Qian said. 1st and 2nd graders received 1 hour of online homework daily, while 3rd to 6th graders had 2.5 hours of online homework a day.

From the age of eight, the girls in the study developed myopia at a younger age than boys, a finding consistent with previous research. The right eyes were more often short-sighted than the left.

A similar increase in myopia probably occurred in the United States and anywhere else where children have been confined at home, Cooper said. “I think everyone is aware that the COVID pandemic also contributed to the myopia pandemic,” he said.

With the pandemic “far from over,” public health authorities should take those findings into account, Qian said. “You may need to carefully consider a smart lock, plan indoor life and not restrict outdoor play in younger children.”

Another possibility could be to use video projectors, which allow children to see their homework at a distance of a couple of meters, suggested co-author Jiaxing Wang, MD, PhD, a postdoctoral researcher at the Emory Eye Center in Atlanta, Georgia, in the comments. online submission section.

Researchers are planning a follow-up study to see if the prevalence of myopia decreases as children return to outdoor play. “We hope that part of the myopia is due to an accommodating and easily reversible excess,” Wang said.

Evidence from other studies suggests that programs that encourage young children to spend more time outdoors may reduce the risk of myopia.

In one such study, also presented at this meeting, researchers at Changhua Show Chwan Hospital in Changua, Taiwan, examined the presence of myopia in school children before and after a program that discouraged work. close nearby and encourage outdoor activities for 120 minutes a day. The prevalence of myopia decreased from 15.4% to 9.1% from 2014 to 2019 in children aged 5 and 6 years. In older children, the effect was more modest.

For older children, prescribe atropine or orthokeratology may be more effective than increasing outdoor time, said Yu-Chieh Yang, an ophthalmology resident who presented the finding.

Qian, Wang, Yang or Cooper have not revealed any relevant financial relationship.

Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO): “The Critical Period of Myopia, Information on Myopic Change in School-Age Children After Home Confinement COVID-19” and “The Critical Period of Myopia myopia, information on myopic change in school-age children after confinement at home COVID-19 “.
Both presented on May 3, 2021.

Laird Harrison writes about science, health, and culture. His work has appeared in national magazines, newspapers, public radio and websites. He is working on a novel about alternative realities in physics. Harrison teaches writing at the Writers Grotto. Visit it at www. lairdharrison.com or follow him Twitter: @LairdH





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