“Remote education, during this unprecedented situation, has not only changed the patterns of digital display usage but has had a far-reaching impact on students’ lifestyle,” researchers recently noted. A team based in Spain has determined that taking online lectures during the COVID-19 pandemic is independently associated with exhibiting dry eye disease (DED) symptoms in university students. Despite an overall lower prevalence of DED risk factors in students attending online lectures, these students obtained significantly higher Ocular Surface Disease Index (OSDI) scores than students attending traditional in-person lectures.

The study conducted an in-depth survey based on several validated questionnaires and risk factor-related inquiries in 812 university students (mean age: 21.5). Participants were divided into two groups based on the number of hours per week spent on online lectures: online group (≥3hr of online lectures per week) or in-person group (<3hr of online lectures per week).

By the time the survey was sent, participants (64.4% online vs. 35.6% in-person) had been attending lectures for a total of 11 weeks (78 days) under their respective teaching modality. Respondents completed three DED questionnaires: the OSDI, Five-item Dry Eye Questionnaire and Eight-item Contact Lens Dry Eye Questionnaire. They were also surveyed on dry eye risk factors, as defined by the Tear Film and Ocular Surface Society Dry Eye Workshop II, in addition to other factors potentially linked to dry eye.

The researchers noted that students taking online lectures used the computer more, spent less time outdoors, exercised more, wore a face mask for less time, experienced fewer allergies and fewer psoriasis episodes and had a higher OSDI score. Multivariate logistic regression analysis revealed that the weekly time spent attending online lectures was independently associated with a positive OSDI score. The study also found no statistically significant age or sex differences between groups.

Despite the strongly evidenced link between online lectures and higher OSDI scores, no relationship was found with either of the symptomatology questionnaires. The researchers suggested that might be because of the differences among questionnaires.

“Given the rise in education technology worldwide and the likelihood of online learning becoming an integral part of student life, clinicians should be aware of the potential impact of online education on DED and its causal factors to respond with the most appropriate preventive and treatment strategies,” the study authors concluded.

Talens-Estarelles C, García-Marqués JV, Cervino A, García-Lázaro S. Online vs. in-person education: evaluating the potential influence of teaching modality on dry eye symptoms and risk factors during the COVID-19 pandemic. Eye Contact Lens. July 1, 2021. [Epub ahead of print].