Purpose: To evaluate myopic progression in school aged Egyptian urban children secondary to online learning during the COVID19 pandemic.
Patients and Methods: A cohort study of 105 children aged 8–16 years with myopia of -0.75D or greater. Inclusion criteria were the presence of hospital records for at least two years before presentation and one year after, minimum 6 months of online learning. Patient demographics, type of device, duration of device use, and changes in myopia (over time) were recorded.
Results: The mean age was 12±2 with 51.4% males and 48.6% females. The average daily screen time was 5 ±1 hours. Tablets were the predominant device used (48.6%), 43.8% of children had a break time of 60 minutes, and 37.1% of children had > 2h of daily outdoor activities. The rate of annual myopia progression was significantly higher during the target period of online learning (MP(T) = -0.61 D±0.24) compared to myopia progression in the year before (MP(B) = -0.54 D ±0.2) and the year after (MP(A) = -0.53 D±0.21) (p value 0.005& 0.019 respectively). MP(T) significantly increased in children who stayed greater than or equal five hours in front of screen compared to the year before and after online learning (P=0.009, 0.017 respectively), with less than two-hour outdoor activity (P value 0.003 & 0.005 respectively) without taking a break (P=0.004).
Conclusion: Online learning and lack of outdoor activities during the COVID19 pandemic significantly accelerated myopia progression rate in Egyptian urban children.