Abstract
PurposeThe outbreak of coronavirus disease 2019 (COVID-19) has caused many children to stay indoors. Increased near work and insufficient outdoor activities are considered important risk factors for myopic progression. This study aimed to compare the changes in myopic progression before and after COVID-19 in children treated with low-concentration atropine.MethodsThe records of 103 eyes of 103 children who were treated with low-concentration atropine eye drops were retrospectively reviewed. We classified children according to the concentration of atropine eye drops and children’s age. The beginning of the pre-COVID-19 period was set from January 2019 to May 2019, and the endpoint was set in March 2020. The beginning of the post-COVID-19 period was set in March 2020, and the endpoint was set from January 2021 to March 2021. We evaluated the questionnaires administered to children’s parents.ResultsA significant myopic progression was observed in the post-COVID-19 period compared to the pre-COVID-19 period in the 0.05% and 0.025% atropine groups (P < 0.001 and P = 0.020, respectively). For children aged 5 to 7 and 8 to 10 years, the axial elongations were significantly faster in the post-COVID-19 period than in the pre-COVID-19 period (P = 0.022 and P = 0.005, respectively). However, the rates of axial elongation and myopic progression were not significantly different between pre- and post-COVID-19 in children aged 11 to 15 years (P = 0.065 and P = 0.792, respectively). The average time spent using computers and smartphones and reading time were significantly increased, and the times of physical and outdoor activity were significantly decreased in the post-COVID-19 period compared to the pre-COVID-19 period.ConclusionsThe rates of myopic progression have increased substantially after the spread of COVID-19 with an increase in the home confinement of children. Therefore, it is necessary to control the environmental risk factors for myopia, even in children undergoing treatment for the inhibition of myopic progression.
Highlights
Myopia is one of the most common ocular disorders worldwide
The beginning of the pre-COVID-19 period was set from January 2019 to May 2019, and the endpoint was set in March 2020
The beginning of the post-COVID-19 period was set in March 2020, and the endpoint was set from January 2021 to March 2021
Summary
Myopia is one of the most common ocular disorders worldwide. In addition to genetic susceptibility, several environmental factors, such as prolonged near work, increased digital screen time, and insufficient time spent outdoors, are recognized as important risk factors for myopic progression [1,2,3,4]. To control the epidemic of myopia, low-concentration atropine eye drops and specially designed contact lenses and spectacle lenses, such as defocus incorporated multiple segments (DIMS) lenses and aspherical lenslets, are recommended to reduce myopic progression and have reached high levels of evidence [5,6,7]. To control the spread of COVID-19, many countries have locked down their cities in conjunction with the WHO’s recommendations and encouraged people to stay indoors. According to the United Nations Educational, Scientific and Cultural Organization, more than 160 countries have closed schools to limit the spread of COVID-19. This measure involves more than 87% of the world’s student population [10]
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