Seasonal variation in myopia progression and ocular elongation

Purpose. To evaluate possible seasonal variations in myopia progression and ocular elongation in school children. Methods. Seventy-one children who were enrolled in a clinical trial of bifocals were examined every 6 months for 30 months. Three 6-month intervals ("winters") included none of the summer vacation from school, and two intervals ("summers") included all of the summer vacation. Myopia was evaluated, after cycloplegia with 2 drops of 1% tropicamide, by automated refractor, and changes in axial length and in vitreous chamber depth were measured by A-scan ultrasonography. Data from left and right eyes were averaged because there was no evidence of a significant eye-visit interaction. Analysis of variance with a planned contrast was used to evaluate differences between the observed rates of change over the two summers compared with expected rates assuming no seasonal effect. Results. For 37 children in single-vision lenses, myopia progression rates over the two summers averaged 0.15 D compared with 0.32 D over the three winters. For 34 children in bifocal glasses, summer rates averaged 0.07 D compared with 0.30 D for winters. Analysis of variance showed that seasonal effects on myopia progression were significant (p < 0.025) for both groups for the first summer and approached significance for the second summer. Increases in vitreous chamber depth were also slower during the summer, significantly so (p < 0.01) for both summers in the single-vision group and for the second summer only in the bifocal group. Changes in axial length were somewhat slower in the summer, but the effect of season reached statistical significance in that variable only for the second summer in the bifocal group (p = 0.031). Conclusion. Myopia progression rates were slower during the 6-month periods that included all of the summer vacation than would be expected assuming no seasonal effect. Ocular growth was also slower in the summer; but that trend, in most cases, was statistically significant only for changes in vitreous chamber depth and not for axial length.