Prevalence and associated factors for self-reported symptoms of dry eye among Thai school children during the COVID-19 outbreak.

PURPOSE: COVID-19 pandemic caused an increase in digital screen time, which seemed to increase the prevalence of dry eye symptoms among the population with abnormally high digital screen usage hours. However, there are no reports of dry eye symptoms in school children with high digital usage hours. Therefore, the present study aimed to assess the prevalence of dry eye symptoms and evaluate the associated factors among school children aged 12 to 18 years during the COVID-19 outbreak. METHODS: Multistage cluster sampling was applied, and six sections of online questionnaires were distributed to selected respondents in November 2021. The odds ratio (OR) with confidence intervals (CIs) for the factors was calculated using binary logistic regression. All statistical significance was determined at p < 0.05. RESULTS: The findings revealed that 62.5% of 603 students showed symptoms of dry eye (DEQ-5 score ≥ 6). Significant associated factors included being female (adjusted OR (aOR) 1.54; 95% CIs 1.05-2.25), higher-grade student (aOR 1.77; 95% CIs 1.23-2.57), digital screen time use (6 to < 12 hours: aOR 2.00; 95% CIs 1.12-3.57, ≥12 hours: aOR 2.54; 95% CIs 1.39-4.76), and perceived stress (aOR 1.12; 95% CIs 1.08-1.16). The Thai-Perceived Stress Scale-10 scores were positively correlated with the scores on the 5-item dry eye questionnaire (Spearman's r = 0.38, p-value < 0.01). CONCLUSION: A high prevalence of dry eye symptoms might be common among school children during the COVID-19 outbreak. Significant risk factors include being female, being a higher-grade level student, prolonged use of digital screens, and perceived stress. However, contact lens use, smoking, and the most common digital device usage patterns were not found to be contributing factors.

Outbreak of COVID-19-Related Myopia Progression in Adults: A Preliminary Study.

Purpose: The COVID-19 pandemic has necessitated specific public health measures, resulting in the alteration of lifestyles, such as increased digital screen time and fewer outdoor activities. Such conditions have increased the progression of myopia in children. However, no investigation of myopia progression in early adulthood has been conducted during this period. Consequently, this study aimed to evaluate the outbreak of COVID-19-related myopia progression among adults at an optometry clinic during the COVID-19 pandemic. Materials and Methods: This was a retrospective cohort study in which participants aged 18-25 years who first visited (baseline) the optometry clinic between June 2019 and March 2020 were recruited for follow-up from November 2021 to March 2022. Spherical equivalent refraction (SER), uncorrected distance visual acuity (UCDVA), and binocular cross cylinder (BCC) were recorded at baseline and a follow-up visit. Using questionnaires, a survey was conducted to assess the lifestyle changes that transpired during the COVID-19 pandemic. Results: In total, 37 participants with a mean age of 22.5±1.4 years were enrolled, of which 89.2% were female. Following the outbreak of the COVID-19 pandemic, most participants self-reported increased daily use of digital devices (89.2%), online education (86.5%), and spending more time at home (94.6%), which increased by approximately 7.6±3.2 hours, 5.9±1.7 hours, and 13.2±7.5 hours, respectively. There were statistically significant differences between SER and BCC at baseline and after approximately 2 years of the COVID-19 pandemic (p < 0.05). The mean two-year myopia progression was -0.59±0.67 D (Maximum = 0.00 D, Minimum = -3.38 D). Conclusion: This study revealed that myopia could progress during adulthood among those who have lived under public health measures intended to address the COVID-19 pandemic.

Coronavirus disease 2019 outbreak and associated public health measures increase the progression of myopia among children and adolescents: Evidence synthesis.

PURPOSE: Although studies have suggested that the coronavirus disease 2019 (COVID-19) outbreak increased myopia progression, they had different settings and analysis methods. This study compared myopia progression before and during the COVID-19 outbreak using meta-analysis. METHODS: Relevant literature was searched on EMBASE, PubMed, ClinEpiDB and Web of Science and reviewed until 8 October 2021. The Newcastle-Ottawa Scale was used to evaluate the quality of the original studies. The mean difference of change in spherical equivalent refraction (SER) was used for evaluation before and during the COVID-19 pandemic. RESULTS: The meta-analysis included eight studies with 773, 797 individuals aged 5-18 years. Pooled analysis indicated that the mean difference of annual myopia progression during the pandemic was 0.41 D higher (95% confidence interval [CI]: 0.35-0.48, p < 0.01) than before the pandemic. Subgroup analysis using cycloplegic (mean difference, 0.30 D; 95% CI, 0.22-0.38; p < 0.01) or noncycloplegic refraction (mean difference, 0.60 D; 95% CI, 0.27-0.93; p < 0.01) indicated that the mean difference of annual myopia progression during COVID-19 significantly increased in both refractive measurements. CONCLUSION: Our findings demonstrated that the COVID-19 pandemic accelerated myopic progression compared to the past. Government policies are urgently required to prevent and control myopia progression.