Myopia risk behaviour related to the COVID-19 lockdown in Europe: The generation R study

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Abstract

Purpose:
To battle the spreading of the COVID-19 virus, nationwide lockdowns were implemented during 2020 and 2021. Reports from China revealed that their strict home confinements led to an increase in myopia incidence. The Netherlands implemented a more lenient lockdown, which allowed children to go outside. We evaluated the association between COVID-19 restrictions, myopia risk behaviour and myopia progression in Dutch teenagers.

Method:
A total of 1101 participants (mean age 16.3 ± 3.65 yrs) completed questionnaires about their activities before, during and after lockdown (March–October 2020). We used a repeated-measures ANOVA to compare time use between these time periods. Ocular measurements were acquired before the COVID-19 pandemic when participants were 13 years old; only 242 participants had ocular measurements at 18 years of age at the time of this analysis. Linear regression analyses were used to evaluate the association between lifestyle factors and myopia progression.

Results:
Children were on average 16.2 (1.03) years of age during lockdown. Total nearwork increased from 8.11 h/day to 11.79 h/day, and remained higher after lockdown at 9.46 h/day (p < 0.001). Non-educational nearwork increased by 2.22 h/day (+49%) during lockdown and was associated with faster axial length progression (B 0.002 mm/h/year; SE 0.001 p = 0.03). Before and during lockdown, the mean time spent outdoors was similar (1.78 h/day and 1.80 h/day, respectively). After lockdown, time spent outdoors decreased to 1.56 h/day (p < 0.001).

Conclusion:
The Dutch lockdown significantly increased digitised nearwork in adolescents but did not affect outdoor exposure. The changes in time spent performing nearwork remained after the lockdown measures had ended. We expect that the COVID-19 pandemic may lead to an increase in myopia prevalence and progression in European children.

Original languageEnglish
Pages (from-to)402-409
Number of pages8
JournalOphthalmic and Physiological Optics
Volume43
Issue number3
DOIs
Publication statusPublished - May 2023

Bibliographical note

Funding Information:
The Generation R Study was conducted by the Erasmus Medical Center in close collaboration with the School of Law and Faculty of Social Sciences of the Erasmus University, Rotterdam, the Municipal Health Service Rotterdam area, Rotterdam, the Rotterdam Homecare Foundation, Rotterdam and the Stichting Trombosedienst & Artsenlaboratorium Rijnmond (STAR-MDC), Rotterdam. The authors gratefully acknowledge the contribution of children and parents, general practitioners, hospitals, midwives and pharmacies in Rotterdam. The authors were supported by the following foundations: Oogfonds, ODAS, Uitzicht 2017-28 (LSBS, MaculaFonds, Oogfonds), Netherlands Organization for Scientific Research (NWO; grant 91815655 to C.C.W.K.) and European Research Council (ERC) under the European Union‘s Horizon 2020 research and innovation programme (grant 648268 to C.C.W.K.).

Funding Information:
The Generation R Study was conducted by the Erasmus Medical Center in close collaboration with the School of Law and Faculty of Social Sciences of the Erasmus University, Rotterdam, the Municipal Health Service Rotterdam area, Rotterdam, the Rotterdam Homecare Foundation, Rotterdam and the Stichting Trombosedienst & Artsenlaboratorium Rijnmond (STAR‐MDC), Rotterdam. The authors gratefully acknowledge the contribution of children and parents, general practitioners, hospitals, midwives and pharmacies in Rotterdam. The authors were supported by the following foundations: Oogfonds, ODAS, Uitzicht 2017‐28 (LSBS, MaculaFonds, Oogfonds), Netherlands Organization for Scientific Research (NWO; grant 91815655 to C.C.W.K.) and European Research Council (ERC) under the European Union‘s Horizon 2020 research and innovation programme (grant 648268 to C.C.W.K.).

Publisher Copyright:
© 2023 The Authors. Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.

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