DRY EYE DISEASE IN THE POST-COVID ERA: A STRUCTURED SYSTEMATIC REVIEW OF TEAR FILM DYSFUNCTION, DIGITAL FATIGUE, AND PUBLIC HEALTH CHALLENGES

*Dr. Mahesh Chandra, Dr. Jitendra Singh, Imran Ahmad Ansari, Kunwar Abhinav Singh, Vishnu Datt Tiwari, Ayush Jha

ABSTRACT

Background: Dry Eye Disease (DED) is a multifactorial ocular surface disorder with rising global prevalence. Post-COVID sequelae, digital screen dependence, and prolonged face mask use have intensified its burden, while healthcare disruptions worsened underdiagnosis and undertreatment. Methods: This systematic review followed PRISMA guidelines. PubMed, Scopus, and Google Scholar (2015–2025) were searched for observational, clinical, and interventional studies on adults (≥18 years) addressing DED related to post-COVID effects, mask use, or digital screen exposure. Data extracted included prevalence, diagnostic methods, and treatment outcomes. Results: From 820 records, 22 studies met the inclusion criteria. Pooled global DED prevalence ranged from 5–34%, rising up to 40% post-COVID. Digital screen use (>6 h/day) reduced blink rate (5–7/min vs. 15/min) and increased evaporative DED. Mask-associated DED affected 19–23% of users. Preventive and therapeutic measures included environmental modifications, lubricants, digital hygiene, and emerging anti-inflammatory or neuroprotective therapies. Conclusion: DED is a growing post-pandemic public health issue. Comprehensive screening, patient education, and targeted interventions are essential. Integrating DED management into occupational health, tele-ophthalmology, and post-COVID care is recommended.

Keywords: Kerato-conjunctivitis Sicca, Dry Eye Disease, Post-COVID, Digital Screen Exposure, Mask-Associated Dry Eye, Public Health, Aqueous Deficient Dry Eye and Evaporative Dry Eye Disease.