ArticleTranslational vision science & technology2022
The Cumulative Effect of Multilevel Factors on Myopia Prevalence, Incidence, and Progression Among Children and Adolescents in China During the COVID-19 Pandemic.
Article in Translational vision science & technology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Digital Screen Time and Myopia: A Systematic Review and Dose-Response Meta-Analysis.JAMA network open · 2025Pooled it
- Comparison of myopia progression among Chinese schoolchildren before and during COVID-19 pandemic: a meta-analysis.International ophthalmology · 2023Pooled it
- Refractive status, visual behaviour, and parental myopia in Portuguese schoolchildren and adolescents.BMC pediatrics · 2026Article
- The predictive accuracy of axial length to corneal curvature radius ratio for myopia in children and adolescents.Frontiers in medicine · 2026Article
- Identifying and Managing Pre-Myopia: A Narrative Review.Clinical ophthalmology (Auckland, N.Z.) · 2026Review
- Risk Factors and Cumulative Risk of Comorbid Myopia and Obesity Among Children and Adolescents in Southern China: A Cross-Sectional Study.Health science reports · 2025Article
- Optical and Visual Diet in Myopia.Investigative ophthalmology & visual science · 2025Review
- Students' association of poor eye-use behavior with myopia: focus on study phase.BMC ophthalmology · 2025Article
- Myopia and daylight-A combination of factors.Frontiers in medicine · 2025Article
- Progression of myopia among school-aged children in Guangzhou, China.International journal of ophthalmology · 2025Article
- Superior visual quality outcomes with compound tropicamide eye drops in treating juvenile pseudomyopia.American journal of translational research · 2025Article
- Method comparison and overview of refractive measurements in children: implications for myopia management.BMJ open ophthalmology · 2024Article
- Combined Effect of Outdoor Time and Other Modifiable Factors on Myopia Incidence Among Children and Adolescents - 9 PLADs, China, 2020.China CDC weekly · 2024Article
- Analysis of Refractive Errors in a Large Italian Cohort of Pediatric Subjects Post the COVID-19 Pandemic.Life (Basel, Switzerland) · 2023Article
- Impact of the coronavirus disease 2019 pandemic on the progression, prevalence, and incidence of myopia: A systematic review.Taiwan journal of ophthalmologyReview
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: To estimate the effects of school closures and associated lifestyle changes on myopia in Chinese children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Two cross-sectional surveys recruited 14,296 Chinese students aged 7 to 18 years in November 2019 and June 2020 from which an open cohort study (nested queue design) was derived and used to assess myopia prevalence, incidence, and progression rates (defined as students with progression in myopia severity at the second survey wave among those with myopia at baseline). The severity of myopia was determined by measurements of visual acuity (<5.0) and noncycloplegic refraction (spherical equivalent <-0.50 diopters). Twenty-three myopia-influencing factors were divided into three categories: eye-use habits, lifestyle, and family and subjective factors. Responses to each of these 23 factors were labeled as either positive or negative options and then combined to generate a comprehensive score. Results: Boys and girls were equally represented (50%) and had the same average age (11.5 years) at each wave. The myopia prevalence increased from 48.2% to 60.0%, with 27.1% myopia incidence and 13.2% myopia progression rates for Chinese children and adolescents. Each of the 23 factors was associated with myopia prevalence but had no significant effect on myopia incidence or progression. However, these 23 factors had a cumulative effect on myopia risks; higher scores were associated with more positive factors and lower risk ratios of myopia and vice versa. Except for the progression rate, the myopia prevalence and incidence and risk ratios decreased with higher comprehensive scores. Conclusions: School closures during the COVID-19 pandemic increased the risk of myopia in Chinese children and adolescents due to the accumulation of poor eyesight habits, unhealthy lifestyles, and excessive screen time. Translational Relevance: Rather than focusing on single risk factors for myopia, future myopia prevention strategies should focus on integrating multiple comprehensive approaches across schools, families, and communities.
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