{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T23:24:39Z","timestamp":1793057079125,"version":"4.5.0"},"reference-count":40,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Childhood myopia increased during the COVID-19 pandemic. Limited evidence exists about whether myopia development was reversed or worsened after the lockdown.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine the prevalence of myopia and its associated factors before, during, and after COVID-19 restrictions.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This population-based, repeated cross-sectional study evaluated children aged 6 to 8 years from the Hong Kong Children Eye Study between 2015 and 2021 in 3 cohorts: before COVID-19 (2015-2019), during COVID-19 restrictions (2020), and after COVID-19 restrictions were lifted (2021).<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n All the children received ocular examinations, including cycloplegic autorefraction and axial length. Data about the children\u2019s lifestyle, including time spent outdoors, near-work time, and screen time, were collected from a standardized questionnaire.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The main outcomes were the prevalence of myopia, mean spherical equivalent refraction, axial length, changes in lifestyle, and the associated factors over 7 years. Data were analyzed using descriptive statistics, logistic regression, and generalized estimating equations.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 20\u202f527 children (mean [SD] age, 7.33 [0.89] years; 52.8% boys and 47.2% girls), myopia prevalence was stable from 2015 to 2019 (23.5%-24.9%;\n P<\/jats:italic>\n \u2009=\u2009.90) but increased to 28.8% (\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) in 2020 and 36.2% (\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) in 2021. The mean (SD) time spent outdoors was much lower in 2020 (0.85 [0.53] h\/d;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) and 2021 (1.26 [0.48] h\/d;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) compared with pre\u2013COVID-19 levels (1.40 [0.47]-1.46 [0.65] h\/d). The trend was reversed for total near-work time and screen time. High myopia prevalence was associated with the COVID-19 pandemic (odds ratio [OR], 1.40; 95% CI, 1.28-1.54;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), younger age (OR, 1.84; 95% CI, 1.76-1.93;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), male sex (OR, 1.11; 95% CI, 1.03-1.21;\n P<\/jats:italic>\n \u2009=\u2009.007), lower family income (OR, 1.05; 95% CI, 1.00-1.09;\n P<\/jats:italic>\n \u2009=\u2009.04), and parental myopia (OR, 1.61; 95% CI, 1.52-1.70;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). During the pandemic, mean (SD) near-work and screen times in children from lower-income families were 5.16 (2.05) h\/d and 3.44 (1.97) h\/d, more than from higher-income families (4.83 [1.85] and 2.90 [1.61] h\/d, respectively).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The findings of this cross-sectional study revealed that after COVID-19 restrictions were lifted in Hong Kong, myopia prevalence among children was higher than before the pandemic, and lifestyle did not return to pre\u2013COVID-19 levels. Younger children and those from low-income families were at a higher risk of myopia development during the pandemic, suggesting that collective efforts for myopia control should be advocated for these groups.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.4080","type":"journal-article","created":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T11:11:10Z","timestamp":1679483470000},"page":"e234080","source":"Crossref","is-referenced-by-count":69,"title":["Prevalence of Myopia in Children Before, During, and After COVID-19 Restrictions in Hong Kong"],"prefix":"10.1001","volume":"6","author":[{"given":"Xiu Juan","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China"},{"name":"Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzhou","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ka Wai","family":"Kam","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China"},{"name":"Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangyao","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandy P. H.","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvin L.","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China"},{"name":"Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Ip","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clement C.","family":"Tham","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, The Chinese 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