Major ophthalmological outcomes of the e-learning process in children and guidelines at COVID-19: a concise systematic review

Abstract

Introduction: The effects on human health caused by the severe acute respiratory syndrome of coronavirus 2 (SARS-CoV-2) lead to several problems in the health, highlighted for ophthalmological diseases. The COVID-19 pandemic caused changes in eye care. In this sense, guidelines on safe ophthalmic practice have been developed worldwide. Objective: To present the main guidelines and considerations about the relationship between COVID-19 and eye care, especially to children and strabismus due to prolonged use of electronic devices. Methods: The research was carried out from June 2021 to August 2021 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, following the Systematic Review-PRISMA rules. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: After the selectivity of articles and literary findings through the following descriptors COVID-19, SARS-CoV-2, a total of 58 studies were analyzed, with only 20 medium and high-quality studies selected, according to the rules of the GRADE, and with bias risks that do not compromise scientific development, based on the Cochrane instrument. Early diagnosis and intervention are imperative. A specific set of guidelines for evaluating and managing cases of COVID-19 in children has been established to examine cases of pediatric ophthalmology and strabismus. These measures are necessary, given that the pandemic may still have a long duration. In this regard, although several forms of strabismus can be treated conservatively, without the need for surgery, most require surgical intervention. Strabismus can be treated conservatively for a short period with orthoptic exercises, occlusion therapy, and prism glasses. The teleconsultation platform can provide primary eye care. Prolonging the use of smartphones for e-learning can lead to acute acquired comiche esotropia in children. Conclusion: According to global guidelines, it is imperative to establish more specifically the care of children with strabismus in the COVID-19 pandemic. Examination of children must be performed according to the protocol recommended by the guidelines. Strabismus can be treated conservatively for a short period with orthoptic exercises, occlusion therapy, and prism glasses.