Myopia Progression During COVID19 Pandemic at a Tertiary Care Hospital
DOI:
https://doi.org/10.31674/mjmr.2022.v6i03.003Abstract
Purpose: The lockdown due to the COVID-19 pandemic lead to many countries implementing a population lockdown. This study was designed to investigate the myopic changes that occurred during lockdown due to the COVID19 pandemic in Pakistan. Methods: A prospective, cross-sectional study, was conducted on patients presenting to the out-patients department with symptoms suggesting a refractive problem. Subjects with a Mean Spherical Equivalent (MSE) level of myopia of at least -0.50DS were included. The second group of subjects that had emmetropia (MSE between -0.25DS and +0.25DS) was recruited. All subjects (including adults) underwent cycloplegic refraction and used objective and subjective techniques, to exclude any pseudo-myopia due to accommodation. Results: A total of 900 subjects were enrolled from 4 to 24 years. The myopia group consisted of 473 subjects (256 females) and the emmetropia group consisted of 427 subjects (224 females). There was no statistical difference in the ages of the groups. Both groups showed an increase in their level of myopia, which was statistically higher in the emmetropic group (p<0.001). Further analysis was conducted, splitting the subjects into four age groups: 4-8 years; 9-12 years; 13-19 years; and 19-24 years. All age groups showed an increase in the magnitude of myopia, with the oldest age group showing the least increase, which was statistically significant (p<0.005). Conclusions: An increase in the magnitude of myopia was seen in all subjects and across all age groups, but more so in the younger subjects.
Keywords:
Myopia Progression, COVID19, Lockdown, Refractive ChangesDownloads
References
Alvarez-Peregrina, C. C., Sanchez-Tena, M., Martinez-Perez, C. C., & Villa-Collar, C. C. (2019). Prevalence and Risk Factors of Myopia in Spain. Journal of ophthalmology, 2019, 3419576. https://doi.org/10.1155/2019/3419576
Aslan, F., & Sahinoglu-Keskek, N. (2021). The effect of home education on myopia progression in children during the COVID-19 pandemic. Eye (London, England), 1–6. Advance online publication. https://doi.org/10.1038/s41433-021-01655-2
Atowa, U. C., Wajuihian, S. O., & Munsamy, A. J. (2020). Associations between near work, outdoor activity, parental myopia and myopia among school children in Aba, Nigeria. International journal of ophthalmology, 13(2), 309–316. https://doi.org/10.18240/ijo.2020.02.16
Cao, K., Wan, Y., Yusufu, M., & Wang, N. (2020). Significance of Outdoor Time for Myopia Prevention: A Systematic Review and Meta-Analysis Based on Randomized Controlled Trials. Ophthalmic research, 63(2), 97–105. https://doi.org/10.1159/000501937
Chatki, P. K., & Tabassum, S. (2021). Juxtaposition on Discrete Covid-19 Vaccines: For Rudimentary and Pivotal Cognizance. International Journal of Advancement in Life Sciences Research, 4(4), 1-6. https://doi.org/https://doi.org/10.31632/ijalsr.2021.v04i04.001
Chatterjee, R., & Bhattacharya, S. (2020). Could novel corona virus (SARS-CoV-2) be the evolving face of a new generation of genetically complex epidemiological challenge?. Malaysian Journal of Medical Research (MJMR), 4(2), 42-45. https://doi.org/10.31674/mjmr.2020.v04i02.006
Deng, L., & Pang, Y. (2019). Effect of Outdoor Activities in Myopia Control: Meta-analysis of Clinical Studies. Optometry and vision science : official publication of the American Academy of Optometry, 96(4), 276–282. https://doi.org/10.1097/OPX.0000000000001357
Dirani, M., Tong, L., Gazzard, G., Zhang, X., Chia, A., Young, T. L., Rose, K. A., Mitchell, P., & Saw, S. M. (2009). Outdoor activity and myopia in Singapore teenage children. The British journal of ophthalmology, 93(8), 997–1000. https://doi.org/10.1136/bjo.2008.150979
Eppenberger, L. S., & Sturm, V. (2020). The Role of Time Exposed to Outdoor Light for Myopia Prevalence and Progression: A Literature Review. Clinical ophthalmology (Auckland, N.Z.), 14, 1875–1890. https://doi.org/10.2147/OPTH.S245192
Guo, Y., Liu, L. J., Xu, L., Lv, Y. Y., Tang, P., Feng, Y., Meng, M., & Jonas, J. B. (2013). Outdoor activity and myopia among primary students in rural and urban regions of Beijing. Ophthalmology, 120(2), 277–283. https://doi.org/10.1016/j.ophtha.2012.07.086
Hu, Y., Zhao, F., Ding, X., Zhang, S., Li, Z., Guo, Y., Feng, Z., Tang, X., Li, Q., Guo, L., Lu, C., Yang, X., & He, M. (2021). Rates of Myopia Development in Young Chinese Schoolchildren During the Outbreak of COVID-19. JAMA ophthalmology, 139(10), 1115–1121. https://doi.org/10.1001/jamaophthalmol.2021.3563
Isaacs, D., & Wood, N. (2016). Let's not be short-sighted: Increased outdoor activity reduces myopia. Journal of paediatrics and child health, 52(10), 969. https://doi.org/10.1111/jpc.13358
Jones, L. A., Sinnott, L. T., Mutti, D. O., Mitchell, G. L., Moeschberger, M. L., & Zadnik, K. (2007). Parental history of myopia, sports and outdoor activities, and future myopia. Investigative ophthalmology & visual science, 48(8), 3524–3532. https://doi.org/10.1167/iovs.06-1118
Khodabakhsh, S., Ramasamy, S., Teng, T. Y., & Leng, C. S. (2021). Impact of internet addiction on health anxiety in Malaysian youth during COVID-19 pandemic. Malaysian Journal of Medical Research (MJMR), 5(2), 12-18. https://doi.org/10.31674/mjmr.2021.v05i02.003
Kishore, T., Kunjukunju, A., & Yusof, P. (2022). Adapting to Covid-19 Pandemic: A Critical Literature Review of the Psychological Impact among Nursing Students. The Malaysian Journal of Nursing (MJN), 13(4). https://ejournal.lucp.net/index.php/mjn/article/view/1448
Lanca, C., Yam, J. C., Jiang, W. J., Tham, Y. C., Hassan Emamian, M., Tan, C. S., Guo, Y., Liu, H., Zhong, H., Zhu, D., Hu, Y. Y., Saxena, R., Hashemi, H., Chen, L. J., Wong, T. Y., Cheng, C. Y., Pang, C. P., Zhu, H., Pan, C. W., Liang, Y. B., … Asian Eye Epidemiology Consortium (AEEC) (2022). Near work, screen time, outdoor time and myopia in schoolchildren in the Sunflower Myopia AEEC Consortium. Acta ophthalmologica, 100(3), 302–311. https://doi.org/10.1111/aos.14942
Lu, B., Congdon, N., Liu, X., Choi, K., Lam, D. S., Zhang, M., Zheng, M., Zhou, Z., Li, L., Liu, X., Sharma, A., & Song, Y. (2009). Associations between near work, outdoor activity, and myopia among adolescent students in rural China: the Xichang Pediatric Refractive Error Study report no. 2. Archives of ophthalmology (Chicago, Ill. : 1960), 127(6), 769–775. https://doi.org/10.1001/archophthalmol.2009.105
Ma, D., Wei, S., Li, S. M., Yang, X., Cao, K., Hu, J., Fan, S., Zhang, L., & Wang, N. (2021) (a). Progression of myopia in a natural cohort of Chinese children during COVID-19 pandemic. Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 259(9), 2813–2820. https://doi.org/10.1007/s00417-021-05305-x
Ma, M., Xiong, S., Zhao, S., Zheng, Z., Sun, T., & Li, C. (2021) (b). COVID-19 Home Quarantine Accelerated the Progression of Myopia in Children Aged 7 to 12 Years in China. Investigative ophthalmology & visual science, 62(10), 37. https://doi.org/10.1167/iovs.62.10.37
Nayak, N. (2022). Mucormycosis COVID-19 Coinfection. International Journal of Advancement in Life Sciences Research, 5(1), 1-4. https://doi.org/https://doi.org/10.31632/ijalsr.2022.v05i01.001
Öner, V., Bulut, A., Oruç, Y., & Özgür, G. (2016). Influence of indoor and outdoor activities on progression of myopia during puberty. International ophthalmology, 36(1), 121–125. https://doi.org/10.1007/s10792-015-0091-5
Rose, K. A., Morgan, I. G., Ip, J., Kifley, A., Huynh, S., Smith, W., & Mitchell, P. (2008). Outdoor activity reduces the prevalence of myopia in children. Ophthalmology, 115(8), 1279–1285. https://doi.org/10.1016/j.ophtha.2007.12.019
Sánchez-Tocino, H., Villanueva Gómez, A., Gordon Bolaños, C., Alonso Alonso, I., Vallelado Alvarez, A., García Zamora, M., Francés Caballero, E., Marcos-Fernández, M. Á., Schellini, S., & Galindo-Ferreiro, A. (2019). The effect of light and outdoor activity in natural lighting on the progression of myopia in children. Journal francais d'ophtalmologie, 42(1), 2–10. https://doi.org/10.1016/j.jfo.2018.05.008
Sharma, K., Jyoti (2020). Cross Sectional Study on Knowledge and Practices Among Indian Nurses about Covid 19. The Malaysian Journal of Nursing (MJN), 12(2), 22-27. https://doi.org/10.31674/mjn.2020.v12i02.004
Sherwin, J. C., Hewitt, A. W., Coroneo, M. T., Kearns, L. S., Griffiths, L. R., & Mackey, D. A. (2012). The association between time spent outdoors and myopia using a novel biomarker of outdoor light exposure. Investigative ophthalmology & visual science, 53(8), 4363–4370. https://doi.org/10.1167/iovs.11-8677
Tambunan, D. M., Nurjanah, N., Rahmayanti, S. D., Imelisa, R., & Abdullah, B. F. (2021). Impact of Covid-19 Pandemic on Mental and Emotional Wellbeing among Children: A Systematic Review. Malaysian Journal of Medical Research (MJMR), 5(3), 11-20.5(3), 11-20. https://doi.org/10.31674/mjmr.2021.v05i03.003
Toro, M. D., Bremond-Gignac, D., Brézin, A. P., Cummings, A. B., Kemer, O. E., Kermani, O., Malyugin, B. E., Prieto, I., Teus, M. A., Tognetto, D., Zweifel, S., & Rejdak, R. (2022). COVID-19 outbreak and increased risk of amblyopia and epidemic myopia: Insights from EUROCOVCAT group. European journal of ophthalmology, 32(1), 17–22. https://doi.org/10.1177/11206721211053175
Wang, J., Li, Y., Zhao, Z., Wei, N., Qi, X., Ding, G., Li, X., Li, J., Song, L., Zhang, Y., Yi, R. H., Ning, Y., Zeng, X., Hua, N., & Qian, X. (2020). School-based epidemiology study of myopia in Tianjin, China. International ophthalmology, 40(9), 2213–2222. https://doi.org/10.1007/s10792-020-01400-w
Wang, W., Zhu, L., Zheng, S., Ji, Y., Xiang, Y., Lv, B., Xiong, L., Li, Z., Yi, S., Huang, H., Zhang, L., Liu, F., Wan, W., & Hu, K. (2021). Survey on the Progression of Myopia in Children and Adolescents in Chongqing During COVID-19 Pandemic. Frontiers in public health, 9, 646770. https://doi.org/10.3389/fpubh.2021.646770
Wen, L., Cao, Y., Cheng, Q., Li, X., Pan, L., Li, L., Zhu, H., Lan, W., & Yang, Z. (2020). Objectively measured near work, outdoor exposure and myopia in children. The British journal of ophthalmology, 104(11), 1542–1547. https://doi.org/10.1136/bjophthalmol-2019-315258
Wu, P. C., Tsai, C. L., Hu, C. H., & Yang, Y. H. (2010). Effects of outdoor activities on myopia among rural school children in Taiwan. Ophthalmic epidemiology, 17(5), 338–342. https://doi.org/10.3109/09286586.2010.508347
Wu, P. C., Tsai, C. L., Wu, H. L., Yang, Y. H., & Kuo, H. K. (2013). Outdoor activity during class recess reduces myopia onset and progression in school children. Ophthalmology, 120(5), 1080–1085. https://doi.org/10.1016/j.ophtha.2012.11.009
Xu, L., Ma, Y., Yuan, J., Zhang, Y., Wang, H., Zhang, G., Tu, C., Lu, X., Li, J., Xiong, Y., Chen, F., Liu, X., Xue, Z., Zhou, M., Li, W. Q., Wu, N., Bao, J., Chen, H., Lu, F., Su, J., … Myopic Epidemiology and Intervention Study (2021). COVID-19 Quarantine Reveals That Behavioral Changes Have an Effect on Myopia Progression. Ophthalmology, 128(11), 1652–1654. https://doi.org/10.1016/j.ophtha.2021.04.001
Zadnik, K., & Mutti, D. O. (2019). Outdoor Activity Protects Against Childhood Myopia-Let the Sun Shine In. JAMA pediatrics, 173(5), 415–416. https://doi.org/10.1001/jamapediatrics.2019.0278
Zhang, X., Cheung, S., Chan, H. N., Zhang, Y., Wang, Y. M., Yip, B. H., Kam, K. W., Yu, M., Cheng, C. Y., Young, A. L., Kwan, M., Ip, P., Chong, K. K., Tham, C. C., Chen, L. J., Pang, C. P., & Yam, J. (2021). Myopia incidence and lifestyle changes among school children during the COVID-19 pandemic: a population-based prospective study. The British journal of ophthalmology, bjophthalmol-2021-319307. Advance online publication. https://doi.org/10.1136/bjophthalmol-2021-319307
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Malaysian Journal of Medical Research (MJMR)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.