Impact of COVID-19 Lockdown on Dry Eye Disease Symptoms

Abstract

Aim: evaluate the potential relation between the lockdown during COVID-19 pandemic and symptoms of dry eye disease (DED). Methods: a questionnaire based- study conducted via an electronic survey during the period of COVID19 lockdown. The survey included participants’ demographic data, potential lockdown associated risk factors of DED. Ocular Surface Disease Index questionnaire (OSDI) was applied for diagnosis of DED. A modified questionnaire was utilized for assessing the DED severity. Perceived Stress Scale 4 (PSS-4) and the 4-item Patient Health Questionnaire for Anxiety and Depression (PHQ-4) were used to assess the psychological status as a potential risk factor for DED. Univariate and multivariate logistic regression analysis were used to assess risk factor for developing DED. Multivariate regression analysis was used to study risk factors affecting the severity. Results: The survey included 455 participants. Self-assessed DED was diagnosed in 135 (29.7%) participants based on OSDI scores. Symptoms were mild in 48.1%, moderate in 18.0% & severe in 11.6%. Multivariate logistic regression analysis revealed that increased duration of Visual display terminals (VDT) use during day, presence of anxiety, and increased PSS-4 by one point were significantly associated with increased likelihood of DED by 1.097, 2.167, and 1.792, respectively. Multivariate multiple regression analysis demonstrated that increased severity of DED was associated with longer duration of VDT use during day and increased PSS-4 by one point (p <0.001). Conclusion: The COVID-19 lockdown may have led to increased psychological stress and prolonged use of VDTs, which were significantly associated with increased risk and severity of DED.