TY - JOUR T1 - Myopia incidence and lifestyle changes among school children during the COVID-19 pandemic: a population-based prospective study JF - British Journal of Ophthalmology JO - Br J Ophthalmol DO - 10.1136/bjophthalmol-2021-319307 SP - bjophthalmol-2021-319307 AU - Xiujuan Zhang AU - Stephanie S L Cheung AU - Hei-Nga Chan AU - Yuzhou Zhang AU - Yu Meng Wang AU - Benjamin H Yip AU - Ka Wai Kam AU - Marco Yu AU - Ching-Yu Cheng AU - Alvin L Young AU - Mike Y W Kwan AU - Patrick Ip AU - Kelvin Kam-Lung Chong AU - Clement C Tham AU - Li Jia Chen AU - Chi-Pui Pang AU - Jason C S Yam Y1 - 2021/07/15 UR - http://bjo.bmj.com/content/early/2021/07/15/bjophthalmol-2021-319307.abstract N2 - Background The impacts of social restrictions for COVID-19 on children’s vision and lifestyle remain unknown.Aims To investigate myopia incidence, spherical equivalent refraction (SER) and lifestyle changes among schoolchildren during the COVID-19 pandemic.Methods Two separate longitudinal cohorts of children aged 6–8 years in Hong Kong were included. The COVID-19 cohort was recruited at the beginning of the COVID-19 outbreak, whereas the pre-COVID-19 cohort was recruited before the COVID-19 pandemic. All children received ocular examinations, and answered a standardised questionnaire relating to their lifestyle, including time spent on outdoor activities and near work, both at baseline and at follow-up visits.Results A total of 1793 subjects were recruited, of whom 709 children comprised the COVID-19 cohort with 7.89±2.30 months of follow-up, and 1084 children comprised the pre-COVID-19 cohort with 37.54±3.12 months of follow-up. The overall incidence was 19.44% in the COVID-19 cohort, and 36.57% in pre-COVID-19 cohort. During the COVID-19 pandemic, the change in SER and axial length was –0.50±0.51 D and 0.29±0.35 mm, respectively; the time spent on outdoor activities decreased from 1.27±1.12 to 0.41±0.90 hours/day (p<0.001), while screen time increased from 2.45±2.32 to 6.89±4.42 hours/day (p<0.001).Conclusions We showed a potential increase in myopia incidence, significant decrease in outdoor time and increase in screen time among schoolchildren in Hong Kong during the COVID-19 pandemic. Our results serve to warn eye care professionals, and also policy makers, educators and parents, that collective efforts are needed to prevent childhood myopia—a potential public health crisis as a result of COVID-19.Deidentified participant data are available upon reasonable request from JCSY, ORCID: 0000-0002-5835-208X. ER -