Dry eye disease survey among schoolteachers and children using visual display terminals during COVID-19 lockdown-CODE study (

Background: Lockdown during COVID-19 led to teachers and children shifting to online classes, using visual display terminals (VDTs) for education, resulting in increased screen time. The present study was done to assess and understand the nature and magnitude of the problem and to suggest preventive or remedial measures. Methods: A questionnaire-based cross-sectional study was conducted. The questionnaire was prepared for an online survey (using Google Forms) and circulated among school children belonging to different schools across India using multiple groups on social media. Results: A total of 3327 participants from 46 schools across India participated in the survey. We found a marked rise in cumulative screen time for both teachers and students before and during the lockdown. There was a threefold increase in the number of participants with a cumulative screen time 6 h or more compared to the pre-COVID era. Teachers (older participants) had worse symptom scores than students. Larger screens, like televisions, were better VDTs compared to smartphones, tablets, or laptops. Conclusions: School administrators and policymakers should pay due attention to institutionalizing the guidelines about class duration, appropriate screens, and stipulating break duration during online classes, which will continue to remain the predominant mode of education for teachers and students alike, at least in the near future.