The COVID-19 pandemic was associated with a 20% increase in the risk of refractive astigmatism, a Hong Kong study has found.
Astigmatism can cause blurred vision at near and distance. It is common among schoolchildren and associated with ametropia. Although the COVID-19 pandemic generated a surge in myopia prevalence in children, the association with child astigmatism remains unknown, the study authors said.
The study examined a cohort of more than 21,000 primary school-aged children.
It found the prevalence rate of refractive astigmatism of at least 1D increased from 21.4% in 2015 to 34.7% in 2022–2023, and corneal astigmatism of at least 1.0D increased from 59.8% to 64.7%.
… the investigators concluded that the pandemic was associated with a 20% increase in the risk of refractive astigmatism
After adjusting for sociodemographic factors, parental astigmatism, and child myopia, the investigators concluded that the pandemic was associated with a 20% increase in the risk of refractive astigmatism (OR 1.20, 95% CI 1.09–1.33, P<0.001) and a 26% increase in the risk of corneal astigmatism (OR 1.26, 95% CI 1.15–1.38, P<0.001) compared with the pre-pandemic period of 2015–2019.
“The potential impact of higher degrees of astigmatism may warrant dedicated efforts to elucidate the relationship between environmental and/or lifestyle factors, as well as the pathophysiology of astigmatism,” the authors concluded.
The study was published in JAMA Ophthalmology.1
Reference
- Kam KW, Shing E, Yam JC, et al. Prevalence and severity of astigmatism in children after COVID-19. JAMA Ophthalmol. 2025 Mar 20:e250205. doi: 10.1001/jamaophthalmol.2025.0205. Epub ahead of print.
