American Academy of Optometry, Oct 2020, Poster
Amy Nau, Olivia Nau, Reeti Rawal,
Korb & Associates, Korb Research, Boston
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. The purpose of the study was to determine if symptoms of dry eye were present in middle and high school students, and whether symptoms were associated with online learning environments.
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 COVID 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.
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 (p<.001), hours of sleep (p<.001), and screen time (p<.001) were all associated with a higher SPEED score (unpaired Student’s t-test). 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.
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. However, even before the increased expected computer use associated with remote education, about half of students had symptoms consistent with dry eye. Educational institutions that have transitioned to hybrid and virtual learning environments in the upcoming school year should query their students about increases in dry eye symptoms. Parents and their children should be educated about preventative measures such as taking breaks, blinking and meibomian gland self-care.