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 Table of Contents  
Year : 2021  |  Volume : 33  |  Issue : 3  |  Page : 392-393

The indirect effect of emerging infectious diseases such as coronavirus disease 2019 on myopia progression

Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran

Date of Submission19-Sep-2021
Date of Acceptance20-Sep-2021
Date of Web Publication08-Dec-2021

Correspondence Address:
Dr. Ali Nouraeinejad
Tehran University of Medical Sciences, Tehran
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/kjo.kjo_195_21

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How to cite this article:
Nouraeinejad A. The indirect effect of emerging infectious diseases such as coronavirus disease 2019 on myopia progression. Kerala J Ophthalmol 2021;33:392-3

How to cite this URL:
Nouraeinejad A. The indirect effect of emerging infectious diseases such as coronavirus disease 2019 on myopia progression. Kerala J Ophthalmol [serial online] 2021 [cited 2022 Jan 19];33:392-3. Available from: http://www.kjophthal.com/text.asp?2021/33/3/392/331940

Dear Sir,

This is to bring an important global issue to the attention. Myopia is a remarkable global public health and socioeconomic crisis.[1],[2],[3],[4],[5],[6],[7] East Asia, and other regions of the world to a lesser scope, has been affected with a rising prevalence of myopia.[8],[9] Based on the prevalence data and the corresponding population figures worldwide, more than half of the world population is anticipated to be myopic by 2050.[1],[2],[10] In addition to the cost and public health significance, this will hugely impact on quality of life and individual productivity of the affected people.[1],[2]

In recent years, emerging infectious diseases (EIDs) such as coronavirus disease 2019 (COVID-19) and influenza A virus subtype H1N1 have become rising dangers to public health on a global level[11] enforcing people to be quarantined indoor.[1],[2],[12] This consequently results in home confinement during the pandemic thereby increasing time spent on near work and increased screen time at home.[1],[2],[12]

The COVID-19 pandemic has also enforced many educational systems to reflect on alternative methods such as remote electronic learning strategies.[2] Since the resultant behavioral and health significance of electronic learning have not been properly studied, it may be posing adverse risks for individuals, especially young children whose sensory functions are maturing through critical development.[1],[2] This is for the fact that increased electronic learning involvement with digital screens and reduced outdoor activities are known as undesirable risks for myopia development.[1],[2],[13]

The outbreak and spread of the COVID-19 pandemic are substantially impacting people's lives by reshaping daily physical and learning behaviors.[2],[13] This will add up to an already global vision crisis.[2],[13],[14] Since these EIDs are continually developing worldwide, they are expected to impact on the behavior of people pressurizing them to stay more often at home and this is going to come about quite often in the future.[[1],[2],[3] Therefore, this will add more chances of getting myopia in the future due to the association of myopia progression and near work imposed by home confinement.[1],[2] Children's refractive errors are more sensitive to environmental changes than older ages.[1],[12] Thus, home confinement will impact more on young children.[1],[2],[3]

Since the inadequate time spent outdoor[1],[2],[12],[15],[16] and increased duration and intensity of near work activities[1],[2],[12],[17],[18] have been found as chief environmental risk factors for myopia progression, home confinement will lead to the development of the myopic crisis further.[1],[2],[3]

The outstanding upward trend for the development of myopia coincides with the age at which schooling with rigorous near work activities begins.[1],[2],[18],[19] As a result, it is imperative to consider the influence of home confinement in the development of myopia particularly in school-aged children while they are in quarantine, and then suggest essential measures to protect them against the progression of myopia.[1],[2],[3]

That is also important to know that axial elongation of the eye related to early myopia increases risks of other ocular diseases including macular degeneration, posterior staphyloma, retinal detachment, cataract, and glaucoma that could cause blindness.[1],[20]

In addition, since myopia onset is becoming increasingly prevalent among young children, predominantly in urban regions[8],[21],[22] and for the fact that the earlier children become myopic, the more likely they develop high myopia, and the worse the prognosis,[23] myopia should be taken priority in health policies.[1],[2]


The author would like to express his honest gratitude and high respect for the lifetime support of his father, Mohammad Nouraeinejad.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Nouraeinejad A. Differential Diagnosis in Optometry and Ophthalmology. 2nd ed. Iran: Noruzi Publication; 2017.  Back to cited text no. 1
Nouraeinejad A. A Warning Message from 2020 to 2050: More than Half of the World Population will be Myopic by 2050. London: Moorfields Eye Hospital; 2020.  Back to cited text no. 2
Nouraeinejad A. The myopia impact. Acta Sci Ophthalmol 2021;4:35-6.  Back to cited text no. 3
Vitale S, Cotch MF, Sperduto RD. Prevalence of visual impairment in the United States. JAMA 2006;295:2158-63.  Back to cited text no. 4
Liang YB, Wong TY, Sun LP, Tao QS, Wang JJ, Yang XH, et al. Refractive errors in a rural Chinese adult population the Handan eye study. Ophthalmology 2009;116:2119-27.  Back to cited text no. 5
Zheng YF, Pan CW, Chay J, Wong TY, Finkelstein E, Saw SM. The economic cost of myopia in adults aged over 40 years in Singapore. Invest Ophthalmol Vis Sci 2013;54:7532-7.  Back to cited text no. 6
Dolgin E. The myopia boom. Nature 2015;519:276-8.  Back to cited text no. 7
Morgan IG, Ohno-Matsui K, Saw SM. Myopia. Lancet 2012;379:1739-48.  Back to cited text no. 8
Morgan IG. What public policies should be developed to deal with the epidemic of myopia? Optom Vis Sci 2016;93:1058-60.  Back to cited text no. 9
Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology 2016;123:1036-42.  Back to cited text no. 10
Venkatesh A, Patel R, Goyal S, Rajaratnam T, Sharma A, Hossain P. Ocular manifestations of emerging viral diseases. Eye (Lond) 2021;35:1117-39.  Back to cited text no. 11
Wang J, Li Y, Musch DC, Wei N, Qi X, Ding G, et al. Progression of myopia in school-aged children after COVID-19 home confinement. JAMA Ophthalmol 2021;139:293-300.  Back to cited text no. 12
Liu J, Li B, Chen Q, Dang J. Student health implications of school closures during the COVID-19 Pandemic: New evidence on the association of e-learning, outdoor exercise, and myopia. Healthcare (Basel) 2021;9:500.  Back to cited text no. 13
Saw SM, Matsumura S, Hoang QV. Prevention and management of myopia and myopic pathology. Investig Opthalmol Vis Sci 2019;60:488-99.  Back to cited text no. 14
He M, Xiang F, Zeng Y, Mai J, Chen Q, Zhang J, et al. Effect of time spent outdoors at school on the development of myopia among children in China: A randomized clinical trial. JAMA 2015;314:1142-8.  Back to cited text no. 15
Lingham G, Mackey DA, Lucas R, Yazar S. How does spending time outdoors protect against myopia? A review. Br J Ophthalmol 2020;104:593-9.  Back to cited text no. 16
Wen L, Cao Y, Cheng Q, Li X, Pan L, Li L, et al. Objectively measured near work, outdoor exposure and myopia in children. Br J Ophthalmol 2020;104:1542-7.  Back to cited text no. 17
Zadnik K, Sinnott LT, Cotter SA, Jones-Jordan LA, Kleinstein RN, Manny RE, et al. Prediction of Juvenile-Onset Myopia. JAMA Ophthalmol 2015;133:683-9.  Back to cited text no. 18
He M, Zeng J, Liu Y, Xu J, Pokharel GP, Ellwein LB. Refractive error and visual impairment in urban children in southern china. Invest Ophthalmol Vis Sci 2004;45:793-9.  Back to cited text no. 19
Tideman JW, Snabel MC, Tedja MS, van Rijn GA, Wong KT, Kuijpers RW, et al. Association of axial length with risk of uncorrectable visual impairment for Europeans with myopia. JAMA Ophthalmol 2016;134:1355-63.  Back to cited text no. 20
He M, Zheng Y, Xiang F. Prevalence of Myopia in urban and rural children in Mainland China. Optom Vis Sci 2009;86:40-4.  Back to cited text no. 21
Theophanous C, Modjtahedi BS, Batech M, Marlin DS, Luong TQ, Fong DS. Myopia prevalence and risk factors in children. Clin Ophthalmol 2018;12:1581-7.  Back to cited text no. 22
Chua SY, Sabanayagam C, Cheung YB, Chia A, Valenzuela RK, Tan D, et al. Age of onset of myopia predicts risk of high myopia in later childhood in myopic Singapore children. Ophthalmic Physiol Opt 2016;36:388-94.  Back to cited text no. 23


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