COVID-19 Lockdowns Increase Myopic Risk Among Adolescents

COVID-19 lockdowns are associated with an increase in behaviors that elevate myopia risk, including increased screen and near work time and decreased outdoor time, according to a study published in Ophthalmic and Physiological Optics. The COVID-19 lockdowns have ended in many places, but these behaviors persist and have not returned pre COVID-19 levels, the report shows. 

Researchers included 760 children (42.0% boys and men; mean age, 16.2 years) from the Generation R Study in an investigation to determine the effects of COVID-19 lockdowns on myopia risk behaviors. Participants completed questionnaires regarding activities before, during, and after the lockdowns. Pre and post COVID-19 ocular biometry measurements were available for 242 participants.

Overall, the time engaging in near work increased from 8.11 hours per day to 11.79 hours per day during the lockdown, and remained high once the lockdown measures were lifted (9.46 hours/day; P <.001). Near work not related to school increased by 2.22 hours per day (+49%) during the lockdown and was associated with faster axial length progression (P =.03). 

The mean time spent outdoors was similar before and during the lockdown (1.78 vs 1.80 hours/day), but these values decreased significantly once restrictions were lifted (1.56 hours/day; P <.001).

Myopia prevalence increased from pre to post lockdown periods — 2.8% for boys and 11.1% for girls, according to the report.

”The COVID-19 pandemic had a prolonged and potentially permanent effect on the behavior of Dutch adolescents that may cause a sharp increase in myopia prevalence and progression in the near future,” according to the study authors. “The study findings highlight the importance of acknowledging and countering myopic progression when a lockdown is imposed, as well as the need to enforce frequent breaks from nearwork and promote engagement in outdoor activities now that lockdowns are becoming less frequent.”

Study limitations include the potential for recall bias.