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Paediatric ophthalmology
Clinical science
Refractive changes in children in the Chicago area during the COVID-19 pandemic: a retrospective observational study
  1. Eugene Kim1,
  2. Magdalena Stec1,2,
  3. Noreen Shaikh2,
  4. Jonathan Huang3,
  5. Hantamalala Ralay Ranaivo2,
  6. Rebecca Mets-Halgrimson2,3
  1. 1 Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  2. 2 Division of Ophthalmology, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
  3. 3 Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  1. Correspondence to Dr Rebecca Mets-Halgrimson; beccamets{at}gmail.com

Abstract

Background Remote learning during the COVID-19 pandemic caused behavioural changes such as increased screen time and decreased outdoor time. This study aimed to investigate myopia progression in children during the COVID-19 pandemic.

Methods This was a retrospective observational study performed among 2064 patients ages 2–17 with cycloplegic refractions in the months of January 2019–March 2021 at a tertiary children’s hospital. Exclusion criteria were a medical history of relevant connective tissue diseases, myopia control treatment, pseudophakia and aphakia.

Results The overall cohort (n=2064) had a mean spherical equivalent (SE) of 0.12±3.70 D in 2019, −0.07±3.95 D in 2020 and −0.49±3.85 D in 2021. The change in mean SE (0.42 D) from 2020 to 2021 was 2.2 times greater than the change (0.19 D) from 2019 to 2020 at baseline. In the cohort of return patients, there was a significant difference in myopic shift between years (F-ratio=14.4, p<0.00001), and a significant change from 2020 to 2021 (p=0.00008) but not from 2019 to 2020. When observing the prevalence of myopia grouped by age, 8-year-old and 17-year-old patients had the greatest increase compared with baseline. When grouped by refractive error, low myopia children (−0.5 D to −3.00 D) displayed the greatest change in mean SE 2020–2021.

Conclusions There was a substantial increase in myopia progression for children in the Chicagoland area after the period of COVID-19 changes. The behavioural changes of home confinement and online learning during the pandemic may explain these findings.

  • Covid-19
  • Child health (paediatrics)
  • Public health
  • Vision

Data availability statement

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Data are available on reasonable request.

https://doi.org/10.1136/bjo-2024-325984

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    Data availability statement

    The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Data are available on reasonable request.

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    Footnotes

    • Contributors EK, MS, NS, HRR and RM-H contributed to the conception and design of the work, as well as the acquisition of the data. EK and JH analysed the data with statistical analysis. All authors contributed to interpretation of the data. EK drafted the article. All authors have revised the article critically for important intellectual content and have read and approved the final manuscript including all subsequent revisions. All authors have agreed both to be personally accountable for the author’s own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved and the resolution documented in the literature. RM-H is the guarantor.

    • Funding This study was supported by an unrestricted departmental grant from Research to Prevent Blindness.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.