Relationship Between Screen Time and Dry Eye Symptoms During the COVID-19 Pandemic in the Pediatric Population of the Western Region of Saudi Arabia

Abstract

To measure the prevalence of dry eye disease (DED) and study the relationship between screen time and dry eye symptoms in the pediatric population during the coronavirus disease 2019 (COVID-19) pandemic using the Ocular Surface Disease Index (OSDI) questionnaire. MethodsIn this descriptive, observational, cross-sectional study, our survey included the pediatric population, ages 1 to 18 years, of both genders, who attended outpatient clinics of two main hospitals in Jeddah, Saudi Arabia. Collected data included age, gender, dry eye symptoms, and common DED risk factors, followed by the Ocular Surface Disease Index (OSDI) questionnaire, which consists of 12 items graded on a five-point scale (0 = never to 4 = all the time). ResultsA total of 329 pediatric participants were included, with more than half of the participants (56.1%) males and 58.5% aged 12-18 years. The most frequently reported symptoms (reported as often or always) were decreased vision (23.0%) and itchy eyes (22.1%). Environmental factors have an effect on developing DED symptoms, as some participants (21.8%) have reported being uncomfortable in windy weather and 15.8% have reported this in places with air conditioners. Based on the OSDI diagnostic criteria, 250 (76.1%) participants had DED. Furthermore, in terms of severity, 44 (13.3%) participants had mild DED, 62 (18.8%) participants had moderate DED, and 145 (43.9%) participants had severe DED. We found that prolonged exposure to mobile screens for two to three hours or four hours or more was associated with a higher DED incidence compared to those exposed for shorter periods. Older age categories were more likely to experience DED (80.8% and 78.2% in age categories 12-18 and 7-12, respectively, versus 57.6% in the youngest age category (p = 0.001)). Additionally, DED was independently associated with participants with a previous history of eyeglasses prescription and those experiencing dry eyes while using electronic devices. ConclusionSince many children use electronic devices for education and entertainment, we found that symptoms of DED due to prolonged screen time have increased among the pediatric population during the COVID-19 pandemic. Therefore, awareness efforts should be directed to reduce the rate of controllable risk factors like personal computer use. In addition, educational campaigns are warranted to provide all possible preventive measures against DED, especially to children with uncontrollable risk factors for developing DED.

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“…The results of the study showed that 76.1% of participants had symptomatic DED, while 23.9% had no DED. The authors found an increase in the symptoms of DED during the COVID-19 pandemic due to prolonged screen time exposure [ 8 ]. Another study conducted in 2022 by Garca-Ayuso et al aimed to assess the prevalence of DED using the OSDI questionnaire among university students.…”

“…Recent studies published to investigate the prevalence of DED during the COVID-19 pandemic and the effect of e-learning on the development of DED In 2022, Wejdan Alnahdi et al conducted a study to measure the prevalence of DED and its association with screen time in the pediatric population during the COVID-19 pandemic using the Ocular Surface Disease Index (OSDI) questionnaire. The results of the study showed an increase in the symptoms of DED during the COVID-19 pandemic due to prolonged screen time [ 8 ]. Another study conducted by Santa-Cruz-Pavlovich et al in 2023 aimed to assess the difference in the incidence of DED since the onset of online courses started using OSDI.…”

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“…[ 5 , 6 ] Second, the use of electronic devices for education and entertainment prolonged screen time in young people potentially leading to adverse implications on ocular surface health. [ 7 ] A prospective study by Krolo et al . [ 8 ] found that face mask wear also exacerbated dry eye symptoms in VDT users.…”