Progression in refractive error in children during COVID-19 pandemic due to virtual classes: A cohort study

Abstract

Background: The pandemic resulted in increased screen hours in children due to virtual education. The rate of progression of myopia was noticed to be remarkable in the past 2 years. This study is an endeavor to study the effect of increased screen hours during COVID home confinement on the degree of progression of myopia in school children and to evaluate the difference in change of refractive errors with a variation in the screen size of the digital device used. Methods: This was prospective observational study with a retrospective comparison arm, wherein 70 school children (140 eyes) aged 4–18 years were subjected to a cycloplegic refraction test. The difference in spherical equivalent refraction from the year 2018 to 19 was compared with that of the difference observed in the pandemic year 2019–2020. A statistical analysis was also made regarding the correlation of variation in refraction between the different genders, age groups, and screen sizes. Results: Of the 70 children, 29 (41.42%) were girls and 41 (58.58%) were boys. The gadgets being used vary from mobiles to laptops, and the range of screens and sizes varies from 100 cm2 to 500 cm2. Similarly, the duration of device use varied from 4 to 8 h. For 2018, the mean value of the spherical equivalent was −1.69 ± 1.42, for 2019 it was −1.92 ± 1.50 and for 2020 the mean value was −2.61 ± 1.47 for the right eye. The mean value of the spherical equivalent for the left eye in 2018 was −1.68 ± 1.51, in 2019 the value was −1.87 ± 1.58, and in 2020, the mean value was −2.73 ± 1.78. Conclusions: Increased exposure to digital devices during the COVID-19 period has a role to play in the progression of myopia in school-aged children.