Dry Eye Syndrome in the Covid Era


A stable tear film is essential for good vision. In Dry Eye Syndrome, the tear film loses its normal lubrication capacity, which conditions inflammation of the ocular surface, with low vision, dryness and eye pain.

There are two categories of Dry Eye: due to water deficiency (decreased function of the lacrimal gland) and evaporative (alteration of the function of Meibomius glands that produce lipids), which is much more common. Dry Eye is more frequent in females and increases with age, in contact lens wearers and with excessive use of digital platforms.

Eye symptoms, including Dry Eye, are common among COVID-19 patients and may appear before respiratory symptoms. Some measures to control the outbreak are harmful to the eye surface, with many healthy people showing symptoms ocular discomfort, which required the use of artificial tears.

Two major causes are pointed out for the increase of Dry Eye in the COVID era: the bad use of facial masks and increased use of digital platforms. THE incorrect positioning of the mask can diffuse air around the eyes, leading to a rapid evaporation of tears. Until the beginning of the pandemic, 75% of our activities daily activities involved the computer. With teleworking, this activity has increased a lot. If Visual Computer Syndrome (SVC) was already an emerging public health problem, epidemic and global, with a prevalence of 60-90% among computer users, we believe that to date this number has skyrocketed.

SVC occurs when a digital platform is used for more than 3 hours a day, associating visual changes to ergonomic problems and psychosocial stress. Children, the elderly and women are more vulnerable. Children because they position themselves inadequately, do not they control the use of digital devices and do not care about symptoms. Elderly, women after menopause and contact lens wearers have poor surface lubrication ocular and dry eye.

Symptoms of SVC are eye fatigue, red and irritated eyes, severe photophobia, headache, double and cloudy vision, luminous halos and dry eyes. These are associated with musculoskeletal symptoms secondary to inadequate work position: pain cervical, lumbar and carpal tunnel syndrome.

Eye symptoms can be relieved with periodic rest and positioning monitor. Every 20 minutes, it is advisable to look away from the screen for 20 seconds, fixing a target at about 6 meters. The monitor should be 15 to 20 degrees below eye level and about 60 cm. Reading materials should be above the keyboard and under or beside the monitor, so that it is not necessary to move the head to fix them. The position of the monitor should avoid glare, in particular lighting top or windows. The brightness must correspond to the surrounding light: if necessary, use a brightness filter in front of the monitor. Contrast and text size also are important. The chair must be padded, in accordance with the body, and adjusted so that the feet rest on the floor and the wrists on the desk or in the arms of the chair.

Generally speaking, the treatment of Dry Eye often involves changing the working environment, avoiding tobacco, smoke, wind or very dry environments with high air speeds (fans, car heaters, air conditioning). IT IS The use of artificial tears without preservatives is essential.

In the treatment we can associate the occlusion of the lacrimal points, administration of anti-inflammatory drugs, such as corticosteroids and cyclosporine in eye drops or oral tetracyclines and use therapeutic contact. Eyelid hygiene is one of the pillars in the treatment of Dry Eye evaporative. Hot compresses are soothing and can liquefy secretions solidified meibomians. Intense pulsed light therapy may be necessary and clinical trials suggest fatty acid supplements (omega-3 and omega-6) to improve symptoms.

Observation by the Ophthalmologist is essential, who can diagnose and treat disorders such as allergic conjunctivitis, dry eye, dystrophy, blepharitis, exposure keratitis, inadequate blinking, poor eyelid position and the use of medications that aggravate situation. Refractive defects must be treated and, if necessary, prescribed glasses for the computer, to avoid eye strain.

SVC significantly decreases quality of life, since visual health is critical maintaining efficiency at work. Take care of working conditions on the computer, take rest breaks.

Use the face mask properly.

Maria João Quadrado, MD, PhD
Deputy Director Faculty Medicine – Coimbra University
Head Coimbra Eye Bank and Cornea Department
Centro Hospitalar e Universitário de Coimbra