Myopic Progression of Children Before and During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis.

PURPOSE: This study aimed to investigate the progression of myopia in children before and during the COVID-19 pandemic.

METHODS

Online databases were searched for original studies reporting changes in the spherical equivalent refraction (SER) and axial length (AL) of children, both before and during the COVID-19 pandemic.

RESULTS

Twelve eligible studies were identified after database search and screening. In all eligible studies, the annual changes in SER and AL were larger during the COVID-19 pandemic than during the pre-pandemic period. The pooled differences in SER and AL before and during the COVID-19 pandemic were -1.25 standard deviation (SD) and 0.27 SD, respectively. Pooled SER difference before and during the COVID-19 pandemic were -1.47 SD for cohorts with 100% children with myopia, -1.03 SD for cohorts with <100% children with myopia, -1.17 SD for cohorts from East Asia, -1.32 SD for cohorts from the other regions, -1.37 SD for younger cohorts, -1.30 SD for older cohorts, -1.79 SD for cohorts with shorter online education time, and -1.39 SD for cohorts with longer online education time.

CONCLUSION

Home confinement during the COVID-19 pandemic has accelerated the progression of myopia in children, especially in those with myopia or from regions other than East Asia. This systematic review protocol was registered with PROSPERO [CRD420251061387].