Significative effect of COVID‐19 confinement on the evolution of myopia in children and young people in Spain

Abstract

Aims/Purpose: The purpose of this study was to analyse whether the changes in habits during the pandemic confinement have resulted in a significantly greater increase in the dioptres (D) of children and young people compared to those of another year prior to the pandemic Confinement (PC). Moreover, CUVAF, as an objective measure of time spent outdoors, was also investigated in this cohort.Methods: A retrospective observational study was carried out using three different cohorts of participants, one of children (9–17 years old), second one of young people (18–25 years old) and finally, adults (>25 years old) with some degree of myopia (<−0.75D). All of them with at least 3 annual graduation visits (two before March 2020 and one after June 2020). All participants underwent an automatic objective refraction, colour fundus photographs, and CUVAF area picture and measured the area with Fiji programme. All the participants filled out a questionnaire of life style and myopia history. For all statistical analyses, corrected p values <0.05 (two‐tailed) were considered statistically significant using Graphpad 8.0.1 Software.Results: A total of 234 participants were recruited, 138 were children, 80 young people and 16 adults. The data showed that during the PC the 3 cohorts (children, youth and adults) decreased outdoor activities in similar high percentages (78%, 73% and 65% respectively) and similar indoor activities increased (80%, 83% and 75%). However, the children's graduation increased on average 0.51 D (SD ± 0.09) before PC and after PC increase 1.02 D (SD ± 0.11) with high significant increase (p < 0.0001). In the young, the increase was 0.33 D (SD 0.08) before PC and 0.61 (SD ± 0.09) after that (p > 0.01) and in adults it remained stable. There were no differences in the increase in D between children with and without CUVAF during PC, although those who had CUVAF started with lower gains (0.3 D) compared to those who did not (0.5 D) (p < 0.05).Conclusions: The change in habits during the confinement of COVID‐19, with a drastic decrease in outdoor activities and an increase in indoor activities, has led to a significant increase in dioptres in young people and children, being much more pronounced in children. The CUVAF is a valid biomarker to measure the risk of myopia associated with outdoor activities.