Lockdown in Hong Kong promotes myopia progression in schoolchildren : a case report

Abstract

Background: We describe two cases of monocular orthokeratology with rapid myopia progression in the contralateral untreated eye during a time that children stopped attending school due to COVID-19 and switched to an online mode of learning. Case Reports: An 11-year-old female unilateral myopic anisometrope was fitted with an orthokeratology lens only in her left eye. The right eye (non-treated eye) showed myopic progression and axial length elongation, while the left eye (orthokeratology treated eye) showed no change in refractive error or axial length from Jan 2020 to Jun 2020, which was the class suspension period. The change in myopia (spherical equivalent) was -0.50 D in the right eye (non-treated eye) but remained unchanged in the left eye (orthokeratology treated eye). The change in axial length was 0.14 mm in the right eye (non-treated eye) and -0.1 mm in the left eye (orthokeratology treated eye) at around 5 months. A 13-year-old female unilateral myopic anisometrope was fitted with an orthokeratology lens in her left eye. The refractive error of each eye was stable before the class suspension, but myopic progression was demonstrated in both eyes during class suspension. The change in myopia (spherical equivalent) was -0.75 D and -0.50 D in the right eye (non-treated eye) and the left eye (orthokeratology treated eye), respectively. The non-treated eye showed -0.25 D more myopic change than the treated eye in a 4-month interval. Conclusions: Myopia progressed 2 to 5 times faster during lockdown; thus, the change of learning mode and lifestyle under the COVID-19 pandemic are possible risk factors for myopia progression. Protective behaviors and myopia control intervention should be publicized and implemented as promptly as possible.