Increase in Dry Eye Symptoms Among Middle and High School Students After Initiation of Online Learning Due to COVID-19 Pandemic

Nau A, Nau O, Rawal R. Increase in Dry Eye Symptoms Among Middle and High School Students After Initiation of Online Learning Due to COVID-19 Pandemic. American Academy of Optometry (virtual), October 2020.

Purpose

Meibomian gland dysfunction (MGD) is the most common cause of evaporative dry eye in adults and more recently has been shown to occur in adolescents. MGD has been linked to screen use in many studies in both children and adults. We sought to determine if middle and high school students self-reported a change in eye discomfort after initiating full time online learning. Increase in Dry Eye Symptoms Among Middle and High School Students After Initiation of Online Learning Due to COVID- 19 Pandemic. 

Methods

The Patient Evaluation of Eye Dryness (SPEED) questionnaire with additional questions regarding sleep, screen time, and activities was administered online to middle and high school students in Sharon, MA, USA after approval from the school district administration. The survey was deployed 4 weeks after students were placed into full time, online learning during the COV1D pandemic, and 7 weeks after school had been closed. De-identified data was analyzed using descriptive statistics, Shapiro-Wilks test, unpaired student's t-test. 

Results

458 students (38.2% male, 60.3% female, 1.5% other; age range 11-18 years) responded to the survey. The average SPEED score was 8.33 ([SD 4.72), range 0-24), indicating dry eye symptoms were present in this population. The average hours on a screen per day was 5.89 [1.86). 58.3% of respondents were on any type of screen greater than 6 hours per day. Age (pc.001), hours of sleep (pc.001), and screen time (p<.001) were all associated with a higher SPEED score (unpaired Student's Hest). 69.7% of respondents experienced dryness, grittiness, and scratchiness at least some of the time, 71.8% had sore/irritated eyes at least some of the time, 67% admitted to experiencing burning or watering. 93.2% of respondents reported eye fatigue at least part of the time, and only 16.6% of all respondents reported their eyes were never tired. 76.4% of respondents reported that the use of electronics was associated with their symptoms, followed by watching TV (39.3%), reading (37.8%), being outdoors (31.9%), and other activities (25.5%). 22.7% stated symptoms began as a result of online learning. Just over half (51.3%) stated that online learning associated with the pandemic did not affect symptoms and 26% were not sure. 

Conclusion

The majority of middle and high school age students in this study had symptoms of dry eye, Almost one-quarter of respondents stated symptoms only occurred after the initiation of online learning. Educational institutions considering transitions to online learning in the upcoming school year should query their students about increases in dry eye symptoms, and parents.