COVID-19 Pandemic Linked to Meibomian Gland Atrophy in Children

Kid looking at screen in the dark
Researchers link elevated OSDI scores and increased screen time.

This article is part of Optometry Advisor’s conference coverage from the 2021 meeting of the American Academy of Optometry, held in Boston from November 3 to 6, 2021. The team at Optometry Advisor will be reporting on a variety of the research presented by the primary eye care experts at the AAO. Check back for more from the AAO Optometry 2021 Meeting..

With the COVID-19 pandemic and measures such as virtual schooling, children in the US have increased the time they spend on electronic screens. Researchers are now showing that this same cohort is demonstrating elevated ocular surface disease index (OSDI) scores and associated meibomian gland atrophy, suggesting a potential link between ocular surface disease and screen time. Researchers presented their findings at the 2021 American Academy of Optometry meeting, which took place in Boston from November 3 to 6.

The study included 37 children (24 girls, mean age 10.3 years) who had visited the Illinois Eye Institute in the fall of 2020. The researchers conducted eye exams, collected tear film parameters, everted eyelids, and imaged the meibomian glands. Graders assessed meibomian glands atrophy with the Arita scale and their tortuosity with the Halleran scale.

The researchers surveyed children and parents about the children’s electronic screen time and conducted an OSDI survey with the children. They made 2 changes to the standard OSDI survey, which asks about past-week symptoms. They asked children whether light seemed bright to them, instead of asking whether their eyes were sensitive to light. They also asked whether they had eye problems that prevented them from using a computer, smartphone, or tablet, rather than a computer or computerized banking machines.

Twenty children had normal OSDI scores, 7 had mild scores, 5 had moderate scores, and 8 had severe scores. Mean OSDI score was 20.98±19.55. Range was 0 to 70.68.

Controlling for age, gender, race, and ethnicity, the researchers found that modified OSDI scores were linked to meibomian gland atrophy in the left eye (r=0.47 P =.016) but not in the right eye (r=0.30, P =.125). Pearson correlation coefficient maintained that relationship (0.372) in the left eye.

Researchers said OSDI findings were higher than in previous studies of children and that result could be a consequence of increased screen time during the pandemic.

“Eye care practitioners should consider evaluating dry eye symptoms and meibography in children; however, there is a lack of survey instruments and evaluation/grading scales specifically validated in the pediatric population,” the researchers said.

Limitations of the study included limited sample size.

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Sicks L, Moua CN, Liu XJ, et al. Meibomian gland atrophy and dry eye symptoms in children during COVID-19 pandemic. Poster presented at American Academy of Optometry 2021 Annual Meeting; November 3-6, 2021; Boston. Board #74.