Volume 4, Issue 4

Background. School closures and the shift to online learning during the COVID-19 pandemic increased screen time and reduced outdoor activity among children, raising concern about faster myopia onset. Population-based data on myopia among Indian schoolchildren after the pandemic are limited. Methods. A school-based cross-sectional survey was conducted between August and December 2025 in 30 government and private schools in urban Delhi selected by stratified cluster random sampling. Children aged 6–15 years underwent visual acuity testing and cycloplegic autorefraction, and parents completed a questionnaire on outdoor time, screen use, near work and parental myopia. Myopia was defined as a spherical equivalent of −0.50 D or less in either eye. Risk factors were examined using multivariable logistic regression accounting for clustering by school. Results. Of 5,400 eligible children, 4,862 (90.0%) completed the examination. The prevalence of myopia was 21.4% (95% CI 19.9–22.9), rising from 9.8% at 6–8 years to 32.2% at 12–15 years, and high myopia was found in 1.1%. Among myopic children, 61.2% were uncorrected or undercorrected. Myopia was independently associated with older age, female sex, private schooling, parental myopia (both parents: adjusted OR 3.12, 95% CI 2.41–4.04), spending less than 1 hour a day outdoors (adjusted OR 2.08, 95% CI 1.66–2.61) and recreational screen time above 3 hours a day (adjusted OR 1.92, 95% CI 1.53–2.41). Conclusions. About one in five schoolchildren in urban Delhi was myopic after the pandemic, a higher prevalence than reported in earlier surveys of the city. School-based programs that increase outdoor time, limit recreational screen use and provide spectacles are needed.