Abstract
This study aims to investigate the impact of home learning on myopia progression in primary school students during the COVID-19 pandemic and analyze associated risk factors. A visual acuity examination and a non-cycloplegic autorefraction were conducted on the subjects before the outbreak of COVID-19 and after classroom learning resumption, and a questionnaire survey was performed concerning visual behavior, physical activity, sleep duration, among others. The multiple linear regression analysis was utilized to analyze risk factors associated with myopia progression in primary school students. The total prevalence rates of myopia in primary school students before the COVID-19 pandemic and after classroom learning resumption were 17.4% and 42.1%, respectively (P < .001), and the mean spherical equivalent (SE) values were -0.24D and -0.85D respectively. The prevalence of myopia in 5th and 6th graders was significantly higher than that in 1st through 4th graders and the SE values were considerably lower than those in 1st through 4th graders. The multiple linear stepwise regression analysis showed that myopia progression was significantly associated with screen time and the number of parents with myopia. Among them, parental myopia alone accounted for 16% of the variation in SE (ΔSE), and parental myopia and screen time in combination could account for 29% of ΔSE. Home learning during the COVID-19 pandemic accelerates myopia progression in children, so efforts should be made to optimize the educational program for home learning, particularly to diminish daily screen time and meanwhile increase outdoor time.