Progression of astigmatism and myopia in children after school lockdown during the COVID-19 pandemic

Abstract

Abstract Lockdown during the COVID-19 pandemic was found to increase the prevalence of astigmatism and myopia among schoolchildren. This cross-sectional study was conducted to evaluate the effects of the school lockdown during the COVID-19 pandemic on the changes in astigmatism and myopia in children with pre-existing astigmatism. A total of 247 children aged 5-17 years with refractive astigmatism who had been followed up in a pediatric ophthalmology clinic were included in this single-center study. Changes in refractive astigmatism and myopia before and after a year of school lockdown were recorded. A questionnaire focusing on demographic data, digital screen time, daytime outdoor activities duration, daily online classes duration, type of digital devices used, and type of light source used during screen time was administered. The median age of participants was 9.0 years (5, 17). The median cylindrical power and spherical equivalence of the children worsened after school lockdown (p=.011 and p= <.001 respectively). Subgroup analysis by age found that astigmatic progression was significant in primary school children (7-12 years old), while myopic progression was significant in primary and secondary school children (13-17 years old). There was a positive correlation between astigmatism and myopia progression (r (166) = .23, p = .003). During the lockdown, digital screen time and daily online classes duration increased while daily outdoor activities duration reduced. There were accelerated astigmatic and myopic progressions in children after the school lockdown due to the COVID-19 pandemic. Further studies are required to investigate the underlying etiology of the changes in refractive errors in school-going children post school lockdown.