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Chinese study connects home confinement during pandemic to rise in myopia among some children

child playing video games during covid lockdown

Researchers behind the study, published by the medical journal JAMA Ophthalmology, tested the vision of thousands of children age 6 to 13 from 10 elementary schools in Feicheng, China. The researchers — from two hospitals in Tianjin, China, and from Emory University in Atlanta and the University of Michigan in Ann Arbor — conducted the study from 2015 through 2020.

Study shows concerning rise in childhood myopia

The study found the incidence of myopia (nearsightedness) in children 6 to 8 rose in 2020 compared with the previous five years of the study. Myopia makes it tougher to see at a distance because the eyeball is too long or the cornea is too curved; it doesn’t affect the ability to see up close and typically doesn’t impact a student’s academic performance.

In the study, the prevalence of myopia appeared to be about three times higher in 2020 than in other years for 6-year-olds, two times higher for 7-year-olds and 1.4 times higher for 8-year-olds. Substantial increases in myopia weren’t seen in children aged 9 to 13 years. 

Children from age 6 to 8 “may be experiencing an important period for myopia development,” the study says. “Within this age window, the plasticity of myopia is high and myopia control may be easier. Beyond this age window, the plasticity of myopia is low and myopia is harder to control during environmental changes.”

The culprit: At-home learning and increase in digital screen use

The study’s authors say being confined to home during the pandemic appears to be associated with worsening vision among the 6- to 8-year-old Chinese students. The authors believe their study is the first research to justify worries about home confinement potentially contributing to increases in myopia. They say the rise in myopia may stem not only from significantly decreased time spent outside but increased time spent in front of digital screens.

To help curb the pandemic in China, the government shut down schools across the country from January to May 2020. During that time, more than 220 million school-age children were confined to their homes while engaging in virtual learning. In 2020, the researchers tested children’s vision after the lockdown ended.

The study examined the vision of nearly 124,000 children 6 to 13 during the pre-pandemic years of 2015 through 2019 and the pandemic year of 2020. Researchers discovered the prevalence of myopia in the 2020 screenings was greater than the highest prevalence of myopia from 2015 through 2019 for children age 6 (21.5% vs. 5.7%), age 7 (26.2% vs. 16.2%) and age 8 (37.2% vs. 27.7%).

The study’s authors explain that the refractive status (how our eyes bend light) of children 6 to 8 “may be more sensitive to environmental changes than older children, given that they are in an important period for the development of myopia.”

Myopia is what’s known as a refractive error. Other refractive errors include hyperopia (farsightedness), presbyopia (aging of the lens in the eye) and astigmatism (a cornea or lens irregularity that causes blurry vision at all distances).

A large-scale U.S. study published in 2018 found 6.1% of children 5 to 7 and 18.3% of children 8 to 10 had myopia. Overall, myopia affects nearly 30% of the U.S. population. The World Health Organization estimates that myopia could affect half of the world’s population by 2050, up from one-third in 2020.

“Children are more likely to develop myopia if their parents are nearsighted. However, myopia is on the rise overall, especially in kids. No one is exactly sure why, but experts believe it could be related to more time doing close-up tasks indoors like using computers and playing video games,” according to the American Academy of Pediatrics.

Symptoms of myopia include:

  • Blurry vision

  • Squinting to see better

  • Frequent rubbing of the eyes

  • Headaches

An eye doctor typically prescribes eyeglasses or contact lenses to correct a child’s myopia. They may also recommend myopia control treatments, including special myopia control glasses.

The American Academy of Pediatrics suggests parents take the following steps to decrease the risk of myopia among their children:

  • Encourage regular breaks from close-up work (such as doing homework on their computers).

  • Spend plenty of time outdoors.

  • Restrict recreational use of electronic devices.

Keep up with routine eye exams for your children

Another important part of ensuring your child’s vision is the best it can be is to schedule eye exams with a pediatric optometrist or pediatric ophthalmologist. A school-age child should get an eye exam every two years if vision correction isn’t needed. For children who wear eyeglasses or contact lenses, the eye exam should be done annually or as recommended by the child’s eye doctor.

A child’s first eye exam should be at 6 months of age, with follow-up exams at age 3 and before first grade (age 5 or 6).

READ MORE: Follow All About Vision for the latest on COVID-19 and its effects on vision

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