Pandemic-Related Myopia Behaviors Did Not Affect Prevalence in School Initiative

Pandemic-related myopia behaviors, which include increased screen time and less time spent outdoors, did not affect myopia prevalence among pediatric patients who underwent a school-based initiative designed to implement myopia prevention strategies, according to a study published in Acta Ophthalmologica. Although study participants experience a 3-month cessation of the program, its protective effect was not eliminated by the COVID-19-related social restrictions, the report suggests.

Researchers included 9997 preschool-aged students (51.5% boys, mean age, 5.20 years) in the cross-sectional investigation performed between 2019 and 2021. Main outcome measures included changes in pandemic-related myopia behaviors while secondary outcome measures examined myopia prevalence changes. Study participants underwent cycloplegic examinations and their caretakers reported reported changes in screen and outdoor time.  

The pandemic-related restrictions led to an increase in time spent on screen-based devices, the report shows. A total of 42.8%, 45.2%, and 48.9% of participants spent more than 1 hour per day on these devices in 2019, 2020, and 2021, respectively, according to caretaker-reported data (P <.001). These reported values were 35.3%, 38.5%, and 43.0% for children spending 2 or more hours on digital devices for 2019, 2020, and 2021, respectively. The caretakers also reported less than 30 minutes of outdoor time on weekdays in 49.5% of children in 2019, 46.0% of children in 2020, and 41.0% of children in 2021 (P <.001).

However, the report shows that these pandemic-related myopia behaviors did not significantly affect myopia prevalence. This value remained stable between 2019 and 2021 with a prevalence of 9.1%, 10.3%. and 9.4% for 2019, 2020, and 2021, respectively (P =.707).

“The change in near-work and outdoor behaviors at home was more prominent under
tighter social restriction measures and showed a dose–response relationship,” according to the researchers. “However, the prevalence of myopia did not fluctuate significantly despite the 3-month school closure and interruption of the school-based eye care program. Our findings can help to raise awareness of preschool myopia control and emphasize the importance of school-based programs that promote outdoor activity in the postpandemic era.”

Study limitations include a potential for recall bias, a failure to assess the role of potential confounders on myopia prevalence, and a failure to consider non pandemic-related myopia behaviors such as the distance of eyes from near work and whether the children took breaks.