Seasonal variations in the progression of myopia in children enrolled in the correction of myopia evaluation trial

Jane Gwiazda, Li Deng, Ruth Manny, Thomas T. Norton, Kenneth Grice, Christine Fortunato, Cara Weber, Alexandra Beale, David Kern, Sally Bittinger, Debanjali Ghosh, Rosanna Pacella, Leslie Hyman, M. Cristina Leske, Mohamed Hussein, Li Ming Dong, Melissa Fazzari, Wei Hou, Elinor Schoenfeld, Lynette DiasRachel Harrison, Wen Zhu, Qinghua Zhang, Ying Wang, Ahmed Yassin, Elissa Schnall, Cristi Rau, Jennifer Thomas, Marcela Wasserman, Yi ju Chen, Sakeena Ahmed, Leanne Merill, Lauretta Passanant, Maria Rodriguez, Allison Schmertz, Ann Park, Phyllis Neuschwender, Geeta Veeraraghavan, Angela Santomarco, Laura Sisti, Lydia Seib, Donald Everett, Wendy Marsh-Tootle, Katherine Weise, Marcela Frazier, Catherine Baldwin, Carey Dillard, Kristine Becker, James Raley, Angela Rawden, Nicholas Harris, Trana Mars, Robert Rutstein, Daniel Kurtz, Erik Weissberg, Bruce Moore, Elise Harb, Robert Owens, Sheila Martin, Joanne Bolden, Justin Smith, David Kern, Sally Bittinger, Debanjali Ghosh, Benny Jaramillo, Stacy Hamlett, Laura Vasilakos, Sarah Gladstone, Chris Owens, Patricia Kowalski, Jennifer Hazelwood, Connie Crossnoe, Karen Fern, Heather Anderson, Sheila Deatherage, Charles Dudonis, Sally Henry, Jennifer McLeod, Mamie Batres, Julio Quiralte, Giselle Garza, Gabynely Solis, Joan Do, Andy Ketcham, Mitchell Scheiman, Kathleen Zinzer, Karen Pollack, Timothy Lancaster, Theresa Elliott, Mark Bernhardt, Daniel Ferrara, Jeff Miles, Scott Wilkins, Renee Wilkins, Jennifer Nicole Lynch, Dawn D'Antonio, Lindsey Lear, Sandy Dang, Charles Sporer, Mary Jameson, Abby Grossman, Mariel Torres, Heather Jones, Melissa Madigan-Carr, Theresa Sanogo, Jo Ann Bailey, Robert Hardy, Donald Mutti, Richard Stone, Carol Taylor

Research output: Contribution to journalArticlepeer-review

83 Scopus citations


Purpose. To investigate monthly and seasonal variations in the progression of myopia in children enrolled in the Correction of Myopia Evaluation Trial (COMET). Methods. An ethnically diverse cohort of 469 myopic 6- to <12 year-old children was randomized to single vision or progressive addition lenses and followed for 3 years with 98.5% retention. Progression of myopia was measured semiannually by noncycloplegic autorefraction (Nidek ARK 700A) and annually by cycloplegic autorefraction, with the former measurements used in these analyses. The semiannual progression rate was calculated as (change in spherical equivalent refraction between two consecutive semiannual visits/number of days between the two visits) times 182.5. Months were categorized as the midpoint between two visit dates. Seasons were classified as winter (October through March) or summer (April through September). The seasonal difference was tested using a linear mixed model adjusting for demographic variables (age, sex, ethnicity), baseline refraction, and treatment group. Results. Data from 358 children (mean [±SD] age = 9.84 ± 1.27 years; mean myopia = -2.54 ± 0.84 diopters [D]) met the criteria for these analyses. Myopia progression varied systematically by month; it was slower in April through September than in the other months. Mean progression in winter was -0.35 ± 0.34 D and in summer was -0.14 ± 0.32 D, a statistically significant difference (0.21 D, P < 0.0001). The same seasonal pattern was found by age, sex, ethnicity (except in the small sample of Asians), lens type, and clinical center. Conclusions. The slower progression of myopia found in summer is likely related to children's spending more time outdoors and fewer hours in school. The data have clinical implications regarding the time of year and the frequency with which myopic children have eye examinations and the need for precise timing of visits in clinical trials testing new myopia treatments.

Original languageEnglish (US)
Pages (from-to)752-758
Number of pages7
JournalInvestigative Ophthalmology and Visual Science
Issue number2
StatePublished - 2014
Externally publishedYes


  • Children's vision
  • Myopia
  • Refractive error

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience


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