Related Experiment Video
Updated: Oct 6, 2025
Subjective Refraction Test Using a Smartphone for Vision Screening
Published on: October 18, 2024
Significant increase in astigmatism in children after study at home during the COVID-19 lockdown
Yuanyuan Liang1, Tsz-Wing Leung1,2, Jinxiao Tina Lian1,2
1School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR.
Insights
The COVID-19 pandemic school closures led to a significant increase in childhood astigmatism. Refractive astigmatism proportion and magnitude rose, highlighting potential environmental influences on vision development.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Public Health
Background:
- The COVID-19 pandemic prompted widespread school closures, altering children's daily routines and visual environments.
- Evaluating refractive astigmatism changes during this period may offer insights into the etiology of refractive errors.
Purpose of the Study:
- To determine if the proportion of astigmatism among primary school children changed after the COVID-19-related school closure period.
- To assess changes in astigmatism magnitude in children who underwent repeated vision screenings.
Main Methods:
- An observational study compared vision screening data from 2018 and 2020 in primary school children aged 8-10 years.
- Measurements included non-cycloplegic refraction and axial length; parental questionnaires gathered data on near-work and outdoor activities.
Main Results:
- Astigmatism prevalence (Cyl ≥ 0.75 D) increased from 33.9% in 2018 to 49.1% in 2020, a 1.5-fold rise.
- Children aged 9-10 years showed a significantly higher median cylindrical power in 2020.
- Longitudinal data revealed significant increases in cylindrical power (0.35 D) and J0 astigmatism (0.21 D).
Conclusions:
- A significant increase in both the proportion and magnitude of astigmatism was observed following the school closure period.
- These findings suggest a potential link between environmental changes during the pandemic and the development of childhood astigmatism.
- Further research is warranted to elucidate the specific factors contributing to this observed increase.
Clinical Relevance:
Evaluating changes in refractive astigmatism after 'study at home' during the COVID pandemic may shed light on the aetiology of refractive errors.
Background:
To investigate whether there has been a change in the proportion of astigmatism among primary school children after the school closure period during the COVID-19 pandemic.
Methods:
This observational study compared cross-sectional (2018: n = 112; 2020: n = 173) and longitudinal data (n = 38) collected from two vision screenings, one in 2018 and the other after the school closure period in 2020, in the same primary school for children aged 8-10 years. Non-cycloplegic refraction and axial length were measured using an open-field auto-refractometer and IOL Master, respectively. A questionnaire focusing on demographic information, near-work time, and outdoor activities was administered to parents of all participants.
Results:
While there were no significant differences in age, gender, or monthly family income between the two cohorts, astigmatism proportion (Cyl ≥ 0.75 D) in 2020 was 1.5-fold higher than that in 2018 (49.1% vs. 33.9%). The median cylindrical power was significantly higher in 2020 in older children (9 or 10 years old). More importantly, the children participating in both vision screenings had cylindrical power and J0 astigmatism significantly increased by 0.35 ± 0.40 D and 0.21 ± 0.25 D, respectively.
Conclusion:
A significant increase in astigmatism (both proportion and magnitude) was found after the school closure period. Further studies are needed to investigate the origin of this increased astigmatism.
More Related Videos
Related Concept Videos
01:28Angle Closure Glaucoma: Treatment
01:16Focusing of Light in the Eye
01:27Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...