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Global Health
September 21, 2021

Increase in Myopia Reported Among Children During COVID-19 Lockdown

JAMA. 2021;326(11):999. doi:10.1001/jama.2021.14475

Spending less time outdoors and more hours looking at screens during the COVID-19 pandemic contributed to an increase in myopia among children in Hong Kong, an ongoing prospective study reported.

More screen time during COVID-19 shutdowns may have contributed to an increased incidence of myopia among children in Hong Kong.


For children throughout the world, COVID-19 caused major disruptions in daily activities as schools and extracurricular activities shut down. In densely populated Hong Kong, where most families live in high-rises or small apartments, the authors noted that pandemic restrictions curbed children’s already limited opportunities to play outdoors. A previous study in China suggested that pandemic-related lockdowns contributed to an increase in myopia among children.

In the latest study, investigators compared data from 2 cohorts, both aged 6 through 8 years, who received eye examinations and answered questionnaires as participants in the Hong Kong Children Eye Study. One cohort involved 1084 children who were followed up for 3 years prior to the pandemic’s start. The other cohort involved 709 children who were followed up for about 8 months after the pandemic began.

Time spent outdoors decreased in the pandemic cohort from about an hour and a half daily at enrollment to 25 minutes a day 8 months later. Children’s screen time more than doubled from about 2.5 hours a day to nearly 7 hours daily. The estimated 1-year incidence of myopia among children aged 6 through 8 years increased from about 16% before the pandemic to about 27% after it began.

Direct comparison of myopia rates in the 2 groups wasn’t possible because of the differing follow-up periods. Instead, the authors compared estimated 1-year incidence rates for the groups.