Lifestyle changes for Chinese school children during COVID-19 home confinement

A vision-screening program was able to provide data before and after Chinese schoolchildren were confined to home learning during the COVID-19 pandemic. Overall, more hours were spent indoors and less time was spent outdoors during this time, across all age groups. The younger schoolchildren had increased incidence of myopia and faster progression, whereas an increase in the prevalence of high myopia was found in the older children.

Can myopia calculators accurately predict children’s myopia progression?

This study investigated the accuracy of the Brien Holden Vision Institute (BHVI) myopia calculator in predicting myopia progression. The extent of myopia progression over 1-2 years in children corrected with single vision spectacles was accurately predicted by the BHVI myopia calculator in 32-38% of 7-13 year old Hong Kong children. Around one-third progressed more and one-third progressed less than the range predicted by the calculator.

Can orthokeratology be used to slow the progression of anisomyopia?

This meta-analysis investigated the effectiveness of orthokeratology in controlling the progression of anisomyopia (unilateral myopia or bilateral anisomyopia) in Chinese children. Total anisomyopia decreased at 2-year follow up, indicating orthokeratology may be a safe clinical method to slow myopia progression coupled with reducing interocular axial length difference. 

Six year safety data for children wearing soft contact lenses

The long-term safety of contact lens wear in children is a known concern amongst parents and eye care practitioners alike. This six year study demonstrated successful contact lens wear in a group of 8-12 year olds, with no serious contact lens adverse events reported and no change in clinical ocular signs compared to pre-contact lens wear. This demonstrates that children as young as 8 can successfully wear daily disposable contact lenses for multiple consecutive years.

Can using atropine enhance myopia control with orthokeratology?

This meta-analysis of 5 studies of 1, 6 and 12 months duration found that slower axial growth is evident when using orthokeratology in conjunction with atropine as a combined therapy compared to orthokeratology alone. A slowing effect of 0.09mm was seen with the combined approach for up to a 12 month follow-up period. Longer data was not available for the meta-analysis.

Increased myopia during the COVID-19 pandemic

Children aged 6 to 8 years old in China were found to experience a mean -0.30D myopic shift and a significant increase in myopia prevalence during a 5-month long COVID-19 home confinement period. Due to their age and corresponding critical stage in visual development, the change in the children’s environment and lifestyle may have been more responsible for their increased myopia than the increased online learning.

Does myopia occur earlier in children if their parents are myopic?

This multi-ethnic study found that parental myopia was a risk factor for myopia development in pre-school age children. The age the parents became myopic themselves had a dose-dependent effect in their children if both parents had onset of myopia before age 12. Eye care practitioners can use this to identify which children may benefit from early myopia treatment intervention.

How common is microbial keratitis in children wearing orthokeratology?

The risk of microbial keratitis (MK) in orthokeratology-wearing children was shown in a 2013 analysis to be around 14 per 10,000 patient wearing years, but new data indicates that it may be lower. Data gathered from a large group of practices in Russia found MK risk of around 5 per 10,000 patient-wearing years, similar to the risk of daily wear soft lenses. This should increase confidence in fitting orthokeratology to children for myopia control.

What is the effect of uncorrecting, undercorrecting and overcorrecting myopia in children?

This systematic review of 9 studies confirms that under-correction of myopia does not slow progression; rather, at least half of the studies have shown the myopia progression is accelerated. There was no benefit found in overcorrection, and the evidence for un-correction was equivocal. Clinically, this advocates for the full correction of myopia.

Light-emitting glasses alter axial length and choroidal thickness in young adults

Light-emitting glasses worn by young adults for 1-2 hours reduced axial length and increased choroidal thickness by around 20 microns compared to darkness. The study participants viewed a colour-muted television at 5m while indoors, and the changes regressed within 30 minutes. A future myopia treatment to increase ‘outdoor’ time?