Digital Eye Strain among Children in South India: Prevalence and Risk Factors during the COVID-19 Pandemic- Case Study

Aim: To study the prevalence, risk factors, and symptoms of digital eye strain among children who attended online classes during the COVID -19 pandemic in Karnataka (South India).

Methods: A Cross-sectional study of the students between 7 to 16 years of age was done. The children, along with the help of their parents, were asked to fill the online survey form. The questionnaire was based on the Computer Vision Syndrome questionnaire, evaluating the total duration of the digital device used before and during the Covid era, the symptoms of DES, its severity, and frequency.

Results: 300 participants responded to the questionnaire, of which 42.9% were males with a mean age of 13±1.75 years. The mean duration of digital devices used during the pandemic era was a 4.1±1.3 hour which was nearly three times more than the pre-Covid era (1.5 ±1.7 hours). 42% (n= 126) were using digital devices for more than 5 hours compared to 2.7% (n=81) before the Covid era and the most common digital device used being the smart phones (n=186(62%).

The prevalence of DES in our cohort was 51%( 153/300); of these, 26% were mild, 13% were moderate, and 11% were severe. The most common symptoms were itching and headache (54% and 53%), respectively. Multivariate analysis revealed age >14 years (p=0.04), male gender (p= 0.004), smartphone use (p=0.04), use of device > 5 hours (p=0.006) and mobile games for more than 1 hour per day (p= 0.05) as independent risk factor for DES in children.

Conclusion: The prevalence of DES among children in the COVID era has increased. This study emphasizes the side effects of prolonged use of devices, type of device, and distance from the digital device that can harm the ocular surface. Hence, both parents and the children need to be aware of this, try to reduce screen time, and follow a good healthy lifestyle.