Objective and Subjective Behavioral Measures in Myopic and Non-Myopic Children During the COVID-19 Pandemic

Hanieh Mirhajianmoghadam, Amanda Piña, Lisa A Ostrin, Hanieh Mirhajianmoghadam, Amanda Piña, Lisa A Ostrin

Abstract

Purpose: The coronavirus disease 2019 (COVID-19) pandemic required a shift to electronic devices for education and entertainment, with children more confined to home, which may affect eye growth and myopia. Our goal was to assess behaviors during COVID-19 in myopic and non-myopic children.

Methods: Parents completed a questionnaire for their children (ages 8.3 ± 2.4 years, n = 53) regarding visual activity in summer 2020, during the COVID-19 pandemic, as well as during school time and the summer before COVID-19. Children also wore an Actiwatch for 10 days in summer 2020 for objective measures of light exposure, activity, and sleep. Data were analyzed with repeated-measures analysis of variance.

Results: Subjective measures showed that during COVID-19, children exhibited increased electronic device use and decreased activity and time outdoors (P < 0.05 for all), while time spent doing near work was not different than during a typical school or summer session before COVID-19 (P > 0.05). Objective measures during COVID-19 showed that myopic children exhibited lower daily light exposure (P = 0.04) and less activity (P = 0.04) than non-myopic children.

Conclusions: Children demonstrated increased electronic device use and decreased activity and time outdoors during COVID-19, with myopic children exhibiting lower light exposure and activity than non-myopes. Long-term follow-up is needed to understand if these behavioral changes ultimately contribute to myopia progression.

Translational relevance: Children's behaviors changed during the COVID-19 pandemic, which may have implications in eye growth and myopia.

Conflict of interest statement

Disclosure: H. Mirhajianmoghadam, None; A. Piña, None; L.A. Ostrin, None

Figures

Figure 1.
Figure 1.
Questionnaire-derived mean daily hours spent in (A) outdoor time, (B) physical activity, (C) electronic device use, and (D) near work for myopic (filled bars) and non-myopic (open bars) children on weekdays and weekends for the COVID-19 session, a typical summer session, and a typical school session. Error bars represent standard error. Asterisks represent statistically significant differences (P < 0.05) determined by three-way repeated-measures ANOVAs.
Figure 2.
Figure 2.
Children's Actiwatch-measured (A) daily light exposure (lux), (B) time outdoors (hours), (C) physical activity (counts per minute), and (D) sleep duration (hours) for each refractive error group on weekdays and weekends during COVID-19. Error bars represent standard error. *Significance at P < 0.05.
Figure 3.
Figure 3.
Subjective versus objective measures of mean daily (A) time outdoors (hours) and (B) sleep duration (hours) for all children during summer 2020. Solid line represents the 1:1 relationship.

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Source: PubMed

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