To assess the effect of severe acute respiratory syndrome coronavirus-2 infection on the conjunctiva and tear film, 38 patients with confirmed COVID-19 and 31 healthy controls were included in this prospective and observational study. Individuals with COVID-19 formed the patient group, and healthy individuals formed the control group. Conjunctival impression cytology (CIC), TBUT, the Schirmer II test and the ocular surface disease index were evaluated in all participants.

No significant difference was observed regarding the mean age and gender between the groups. The mean TBUT and Schirmer II test results did not differ between the two groups. The CIC results revealed decreased density and cell size of goblet cells, and moderate to high enlargement, squamous changes and increased nucleocytoplasmic ratio in non-goblet epithelial cells in the COVID-19 group compared with the control group. Based on the Nelson classification in CIC samples, 60.6% of the COVID-19 group and 19.4% of the control group had changes consistent with grade 2 or above. The presence of neutrophils in CIC was significantly higher in the COVID-19 group, whereas the presence of lymphocyte was similar between the two groups.

This study revealed the pathological conjunctival alterations in patients with COVID-19 and demonstrated that pathological ocular surface alterations may present even at the beginning of COVID-19 without clinically significant ocular manifestation.

Digital display use has been implicated as a contributing factor for dry eye disease (DED). Abnormal blinking during computer operation, including a reduced blink rate and an incomplete eyelid closure, increased palpebral fissure as a consequence of high visualization angles, and meibomian gland dysfunction associated with long-term display use, are behind the increased prevalence of dry eye signs and symptoms found in digital display users.

Previous research reveals significant reductions in tear volume and stability, alterations in tear film composition including increased osmolarity, inflammatory cytokines, oxidative stress markers and reduced mucin secretion, eyelid abnormalities and ocular surface damage, encompassing corneal and conjunctival staining and bulbar redness, as a direct consequence of digital display use. In this regard, individual differences in the way that the various digital displays are typically set up and used may account for differences in their effects on induced dryness signs and symptoms. Furthermore, factors such as the use of contact lenses or inappropriate working environments, usually accompanying the use of displays, may significantly increase the prevalence and the severity of induced dry eye. Other factors, such as old age and female gender are also relevant in the appearance of associated alterations.

Finally, the authors wrote, clinicians should adopt a treatment strategy based on a multidirectional approach, with various treatments being applied in conjunction.

With the increasing prevalence of myopia, there is growing interest in active myopia control. However, the majority of progressive myopes are still prescribed single vision spectacles. This prospective study aimed to elucidate the knowledge and attitudes of optometrists toward myopia control, and thereby identify perceived barriers to the implementation of a risk-focused model of myopia management. A series of four focus group discussions were conducted involving optometrists in different settings and career stages.

The key finding to emerge is a clear disconnect between academic optometrists, optometry students and clinicians in practice. Academic faculty considered themselves competent in managing progressive myopia and believed the optometry curriculum provides undergraduates with sufficient clinical skills and knowledge to practice myopia control. Final-year optometry students regarded themselves as knowledgeable about myopia control but lack confidence in their ability to practice myopia control, with only one student indicating they would initiate myopia control therapy. The majority of clinicians did not offer myopia control treatments, other than to communicate lifestyle advice to modify risk of myopia progression. Clinicians alluded to a lack of availability of myopia control interventions, and identified a range of barriers relating to their training, clinical practice and public health challenges, in addition to financial, technological and other constraints that affect the implementation of such interventions.

The findings indicated that optometrists have to yet embrace myopia control as a core element of the clinical eye care service they provide. Education, training, finance and time restrictions, as well as limited availability of myopia control therapies were among the main perceived barriers to myopia control. This study revealed a distinct need for alignment between optometric training and the public health need for effective myopia control.