{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T15:46:52Z","timestamp":1782316012254,"version":"3.54.5"},"reference-count":20,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T00:00:00Z","timestamp":1700524800000},"content-version":"unspecified","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,9,22]]},"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed at evaluating refractive changes in German school-aged children before and after the COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>414 eye care professional centres from Germany.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Refractive data from 59\u2009926 German children aged 6\u201315 years were examined over a 7-year period (2015\u20132021).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Spherical equivalent refraction was assessed as a function of year, age and gender. The refractive values concerning 2020 and 2021 were compared with those assigned to prior years (2015\u20132019).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The refractive data associated with 2020 and 2021 showed a myopic refractive shift of approximately \u22120.20D compared with the 2015\u20132019 range. The refractive change was statistically considerable in the 6 to 11-year range (p&lt;0.05), while from 12 to 15 years was negligible (p\u22650.10). Percentage of myopes was also impacted in 2021 (p=0.002), but not in 2020 (p=0.25). From 6 to 11 years, the percentage of myopes in 2021 increased significantly by 6.02% compared with the 2015\u20132019 range (p\u22640.04). The highest percentage increase occurred at 8 and 10 years of age, showing a rise of 7.42% (p=0.002) and 6.62% (p=0.005), respectively. From 12 to 15 years, there was no significant increase in the percentage of myopes in 2021 (p\u22650.09). Percentage of myopes in 2020 was not influenced at any age (p\u22650.06).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Disruption of normal lifestyle due to pandemic-related home confinement appears to lead to a myopic refractive shift in children aged 6\u201311 years in Germany. The greater effect observed at younger ages seems to emphasise the importance of refractive development in this age group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-071833","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T12:41:59Z","timestamp":1700570519000},"page":"e071833","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Evaluating the impact of COVID-19 pandemic-related home confinement on the refractive error of school-aged children in Germany: a cross-sectional study based on data from 414 eye care professional centres"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6242-1685","authenticated-orcid":false,"given":"Pablo","family":"Sanz Diez","sequence":"first","affiliation":[{"name":"Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Germany"},{"name":"Technology and Innovation, Carl Zeiss Vision International GmbH, Aalen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arne","family":"Ohlendorf","sequence":"additional","affiliation":[{"name":"Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Germany"},{"name":"Technology and Innovation, Carl Zeiss Vision International GmbH, Aalen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Jose","family":"Barraza-Bernal","sequence":"additional","affiliation":[{"name":"Technology and Innovation, Carl Zeiss Vision GmbH, Aalen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Kratzer","sequence":"additional","affiliation":[{"name":"Technology and Innovation, Carl Zeiss Vision GmbH, Aalen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siegfried","family":"Wahl","sequence":"additional","affiliation":[{"name":"Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Germany"},{"name":"Technology and Innovation, Carl Zeiss Vision International GmbH, Aalen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,11,21]]},"reference":[{"key":"2025120523372596000_13.11.e071833.1","unstructured":"World Health Organization . 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