Prevalence of symptomatic dry eye disease with associated risk factors among medical students at Chiang Mai University due to increased screen time and stress during COVID-19 pandemic

Abstract

Dry eye disease (DED) is one of the most common ophthalmological disorders, resulting from several systemic and ocular etiologies including meibomian gland dysfunction (MGD). During the COVID-19 pandemic, medical students are among the high-risk group for DED, mainly due to the increasing use of a visual display terminal (VDT) for online lectures and psychological stress from encountering several changes. Our study aimed to explore the prevalence of DED using the symptom-based definition and potential risk factors in medical students. This is a prospective cross-sectional study that included medical students at Chiang Mai University between November 2020 and January 2021. All participants were assessed using the Ocular Surface Disease Index (OSDI) questionnaire, the Thai version of the 10-Item Perceived Stress Scale-10 (T-PSS-10), the LipiView® II interferometer, and an interview for other possible risk factors. Overall, 528 participants were included in the study; half of the participants were female. The prevalence of DED was 70.8%. In the univariate analysis, female sex, contact lens wear, and T-PSS-10 stress scores were significantly higher in the DED group (P = 0.002, 0.002, and <0.001, respectively). Moreover, participants with severe DED were likely to have higher meibomian gland tortuosity but not statistically significant. In the multivariate analysis, contact lens use and T-PSS-10 score were significant risk factors associated with the severity of DED. In conclusions, the prevalence of DED in medical students was as high as 70.8%. Contact lens use and psychological stress evaluated using the T-PSS-10 questionnaire had a significant correlation with a risk of DED. Female gender and duration of VDT use were also associated. Most of the risk factors were modifiable and may be used as initial management in patients with DED.

Evaluation of dry eye symptoms and risk factors among medical students in Serbia

“…Many studies among adults have shown a correlation between DED and contact lens use [10,25]. Several studies among young adults reported similar results [11,22,24,[31][32][33]. DED occurs up to four times more frequently in the population of contact lens users than in the general population [10,25,31].…”

“…A recent study in Thailand observed a DED prevalence of 70.8% among medical students at Chiang Mai University. This study recognized the impact of VD devices and the psychological stress on DED among students during Covid-19 pandemic [ 11 ]. Similar studies conducted during Covid-19 pandemic reported DED prevalence from 51,8% to 71,7%, using different criteria [ 12 – 15 ].…”

“…DED has been shown to be more prevalent among women and the elderly [ 9 , 10 ]. However, several recent studies investigated DED in the young adult population, and reported a prevalence up to 70.8% [ 11 – 15 ]. These findings indicate the possibility of a higher prevalence of DED in this age group than previously thought.…”

An Oral Polyphenol Formulation to Modulate the Ocular Surface Inflammatory Process and to Improve the Symptomatology Associated with Dry Eye Disease

“…DED is one of the most common clinically observed conditions worldwide with an estimated population prevalence of 9–30% [ 29 , 30 , 31 ]. Nevertheless, several scientific reports show that the extensive use of computers and monitors, especially since the onset of the SARS-CoV-2 pandemic, has broadened the impact of dry eye-related visual strain by as much as 70.8% in medical students [ 32 ]. In addition to increased screen exposure, the use of face masks has been associated with a 26.09% exacerbation of DED symptoms and there has been an increment of 18.3% in the number of mask-associated dry eyes [ 33 ].…”

The ocular symptoms and signs during the COVID-19 pandemic

“…During the pandemic, drastic changes in lifestyle and infection control may be associated with DE; however, no study has compared the status of the ocular surface in the general population before and during the pandemic. Some school-based surveys [18][19][20] have reported on the prevalence and severity of DE during this period. However, to the best of our knowledge, clinical data is not sufficient and no study has demonstrated changes in prevalence and objective severity of DE during this period.…”