Increased Screen Time and Dry Eye: Another Complication of COVID-19

Abstract

During a time of relative social isolation because of the coronavirus disease 2019 (COVID-19) virus, electronic devices have enabled people to continue to work, learn, and socialize. The long-term effects of this increase in electronic device use on physical and mental health are unknown and will take years to determine. Before COVID-19, the negative effect of prolonged screen time on the health of the ocular surface was known 1 and the increased use of electronic devices necessitated by the pandemic will exacerbate this problem. 2 In addition, once the current health crisis subsides, many people will continue to work, learn, and socialize remotely through electronic devices so that the effect of screen time on the ocular health will continue to be an issue for the foreseeable future.In India, where COVID-19 continues to overwhelm the health care system, Bahkir and Grandee 3 surveyed 407 people (average age 27.4 years) through social media platforms and found that the average increase in screen time during lockdown was 4.8 6 2.8 hr per day, resulting in an average screen time usage of 8.65 6 3.74 hr. Not surprisingly, 95.8% of respondents experienced at least one symptom related to digital device usage and 56.5% reported an increase in symptoms frequency and intensity during lockdown. 3 This is also true for patients of almost all ages; before COVID-19, in 2018, Sheppard and Wolffsohn 4 reported that 68% of children regularly use a computer by age 3 and 37% of adults aged 60 years and older spend 5 or more hours daily on digital devices. Mineshita et al.'s 1 recent study of 7,419 elementary school children in Japan found that, in addition to dry eye, increased screen time is associated with obesity, decreased physical activity, and reduced academic performance.With all of the mortality and morbidity caused by COVID-19, an increase in ocular surface disease caused by an increase in screen time seems insignificant. However, dry eye disease is associated with increased rates of depression and suicide, 5 both of which maybe increased during a pandemic (although it is still too early to determine the effect of COVID-19 on depression and suicide rates). Therefore, if there are modifiable risk factors for dry eye, now is the time to address them. The decreased blink rate is likely the primary mechanism by which electronic device use worsens dry eye. Patel et al. 6 showed that the blink rate decreased from 18.4 blinks/min before computer use to 3.6 blinks/min during computer use. Now that multiple vaccines are available, COVID-19 restrictions are being lifted in some parts of the world. However, the use of

Changes and correlates of screen time in adults and children during the COVID-19 pandemic: A systematic review and meta-analysis

“…In adults, increases in screen time was consistently associated with dry eye syndrome, which broadly agrees with previous literature in both a COVID-19 and non-COVID-19 context. 120,121 It was also found that more than 6 h of screen time/day was associated with several symptoms of digital eye strain, including tearing, eye strain, dryness, heavy eyelids, red eyes, eye itchiness, burning sensation in the eye, sensitivity of bright light, difficulty focussing, eye pain, the feeling of a foreign body in the eye, and excessive blinking. These results concur with pre-pandemic reviews that have found associations between dry eye syndrome and screen time.…”

Update on overview of ocular manifestations of COVID-19

“…Such smart work models have resulted in the creation of new lifestyles, digital work and digital schooling, and limit young people and adults to long-term near-visual work. However, long-term use of VDTs may disrupt the surface of the eye, resulting in conditions such as DED ( 97 ).…”

Prevalence of SARS-CoV-2 in Conjunctival Swab Samples Among Patients Presenting with Conjunctivitis During the COVID-19 Pandemic

“…Additionally, during the COVID-19 era, several publications suggested an increased incidence of dry eye due to lockdown related environmental changes, including mask use, increased use of screens, and dietary deficiencies. [29][30][31] https://doi.org/10.2147/OPTH.S343793…”