Myopia Progression during COVID-19 Home Quarantine in Indonesia: A Retrospective Multicenter Cohort Study

Purpose: To evaluate the impact of home quarantine on myopia progression in Indonesian children during COVID-19 pandemic. Methods: This multicenter retrospective cohort study included children aged 8-17 years old from 20 hospitals across 9 provinces in Indonesia. Medical records of children diagnosed with myopia and/or astigmatism were obtained and grouped to pre-pandemic (September 2019-March 2020) and pandemic periods (September 2021-May 2022). Patient demographics and spherical equivalents of refraction (SER) were collected. Direct or phone interviews were conducted with questions regarding the child’s screen time, outdoor activity time, break time in between gadget use, and sleep duration. Results: In total, 607 children were enrolled. There was a significant increase in SER progression (-0.97 ± 1.04 D, p<0.001). SER progression in Java-Bali was higher compared to others (-1.3± 1.18 D vs 0.57± 0.67 D, p<0.001). A total of 262 patients were interviewed. Younger age (OR: 2.52, 95% CI:[1.42-5.03], p = 0.004), female gender (OR: 2.16, 95% CI:[1.18-3.83], p = 0.011), screen time of ≥4 hours daily for leisure activities (OR: 1.95, 95% CI:[1.07-3.54], p = 0.028), ≤1 hour of time spent outdoor daily (OR: 1.89, 95% CI:[1.03-3.47], p = 0.047, and sleep duration of >8 hours (OR: 2.7, 95% CI:[1.46-4.99], p = 0.002) were significantly associated with fast myopia progression. Conclusion: Myopia progression was accelerated during COVID-19 home quarantine, especially in more urban area. Collaborative efforts should be made to address this current issue.