Impact Of The Covid-19 Pandemic Lockdowns On Manifest Refraction In A Young Adult Population: A Large Cohort

To evaluate the impact of the COVID-era pandemic on manifest refraction in a young adult population.

6,437 Israeli air force recruits screening before and along the COVID-19 era. Assesment was performed on 2653 patients (40.9%) in the pre-COVID era (2018-2019), and 3828 patients during the COVID pandemic (2020-2021, 59.1%).

A retrospective, observational study of consecutive recruits evaluated between 2018-2021. Data collected included demographics, BCVA and manifest refraction.

Mean age was 17.62 years (range 16-22), 87.5% were male. A significant decrease in the prevalence of myopia was noted following the COVID-19 lockdowns, from 43.5% in the pre COVID-19 era compared to 34.2% in the COVID-19 era (p<0.001). When further stratifying to degree of myopia, a significant decrease during the COVID-19 era was observed in both moderate (3.6% to 1.1%, p<0.001) and mild myopia (39.8% to 33%, p<0.01). Spherical equivalent (SE) signifincantly increased during COVID-19 (-0.47D to -0.22D, p<0.001), meaning that patients had lower myopic tendency. When comparing patients under and over 18, the increase in SE was observed in the younger group only (-0.47D to -0.18D, p<0.001, compared to -0.41D to -0.27D, p=0.05; respectively).

In a very large base population consisting of young adults before and along the COVID-19 era, no increase in myopia was observed despite extent periods of lockdown and homeschooling.