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The COVID Stare and Dry Eye Surge

Dr. Stephanie Ramdass

Dr. Stephanie Ramdass in in clinical practice in Toronto, Canada and is Adjunct Faculty at the Michigan College of Optometry. She graduated from the Inter American University of Puerto Rico School of Optometry and completed a Cornea and Contact Lens Residency at the Michigan College of Optometry (MCO). While at MCO, she als completed a clinical research fellowship at its Vision Research Institute and obtained her MBA degree with a focus on project management. She also completed a Master of Science in Biomedical Sciences. 

Guest Editorial by Dr. Ramdass, OD, MS, MBA, FAAO

Here in Ontario, we are in our third week of stay at home orders from the Federal and Provincial Governments of Canada. COVID-19 related updates come across our TV screens like clockwork, with stricter regulations announced daily than those set from the day prior. New measures to enforce physical distancing when in public spaces are in effect, and fines are issued for residents who do not comply. For many parents, there is an even scarier COVID related restriction - students will likely not return to in-class learning until the fall of 2020, or maybe even later.

The growing concerns from government officials to slow the spread of coronavirus, or SARS-CoV-2, resulted in cancellation of child care services mid-March. Parents have subsequently become responsible for engaging their children throughout the day, every day. They cannot take their kids to a mall or the movies. There are no libraries, museums, or parks open to explore. Children cannot go visit their friends.

The province is in the middle of rolling out a new online education portal to help its two million elementary and high school students learn at home while schools remain closed amid the COVID-19 public health crisis. For example, in one education district, Ontario’s Ministry of Education outlined guidelines for remote learning which at the minimum, includes five hours of work per student per week for kindergarten to grade three students (TDSB, 2020). Let’s say this amounts to one hour of dedicated time of school work per day during the weekdays. It is hard to believe that while at home for the entire day, kids will only be spending this one hour each day in front of a screen.

Just recently, I managed a non-urgent patient call from a mother who was concerned with the frequent blinking exhibited by her five-year-old who needed to wash his eyes with water to prevent them from “getting stuck”. When I questioned mom regarding his digital device use, she reported 6-7 hours intermittent throughout a day, followed by a deflated, “I know it’s too much, but he is screaming when I take it away.” I could hear him yelling in the background as she continued with, “This is so hard for me to be home all day with him.”

Children all over the world are going to be staring at a screen now more than ever. Their blink response will decrease, their eyes will burn and water, and they may rub them more than usual.

Despite recommendations to parents from eye care providers to limit screen time use in children to no more than one to two hours a day, this maximum will be easily exceeded for the duration that quarantine restrictions are in place around the globe. As I told mom above, embrace the screen for its educational use, minimize the stare by decreasing the amount of digital device use, incorporate screen time breaks at frequent intervals, and even use preservative-free artificial tears as a “medicine” scare-tactic that must be instilled when her son stares at a screen for too long.

I commended her for maintaining her sanity and encouraged her to continue to do so in the interim. Once we all get back to our new “normal” and the delivery of routine eyecare resumes, let’s brace ourselves for a likely surge in dry eye related symptoms from our pediatric patient population.

1. Toronto District School Board (TDSB). (2020, April 3). Continuation of Learning in the TDSB -- Message from the Director. Access.