Article Text

Download PDFPDF
Increased short-sightedness in younger children associated with home schooling and confinement
  1. Imran Jawaid,
  2. Ian D Wacogne,
  3. Joseph Abbott
  1. Department of Paediatric Ophthalmology, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
  1. Correspondence to Joseph Abbott, Birmingham Children's Hospital NHS Foundation Trust, Birmingham B4 6NH, UK; joseph.abbott1{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Study question

Objectives: To assess the refractive error of school age children following home confinement owing to the COVID-19 pandemic and to compare findings with preceding years.

Setting: Ten elementary schools in Shandong, Feicheng, China, from 2015 to 2020.

Patients: 123 535 children aged 6–13 years were assessed annually with an automated-refraction device.


During 4 months of home isolation preceding the 2020 assessment, children in grades 1 and 2 (age 6–8 years) were taught online for 1 hour/day, whereas those in grades 3–6 (age 8–13 years) were taught for 2.5 hours/day. Outdoor activity was severely restricted, often to none.

A Spot Vision Screener, an automated assessment of refractive error, was held at 1 m from the patient in the pre-COVID-19 era. In the COVID-19 era (2020), there were three method changes. First, screeners stood at 1.8 m and extended their arms forward to the required 1 m testing distance. Second, masks were worn by the screeners and children. Third, students had their autorefraction in May 2020 rather than September, following easing of COVID-19 restrictions.

The assessment of refractive error in May 2020 was compared with data from September in each of the years 2015–2019, inclusive.


Results for the 6 years, 2015–2020, inclusive, …

View Full Text


  • Review of article Wang J, Li Y, Musch DC et al. Progression of Myopia in School-Aged Children After COVID-19 Home Confinement. JAMA Ophthalmol [Internet]. 2021 Jan 14 [cited 18 Feb 2021]; Available from:

  • Contributors IJ wrote and revised the manuscript. IDW developed the idea and critically reviewed the manuscript. JA has overseen the work with structure and revisions.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.