Survey of Direct and Indirect Effects of COVID-19 on Eyes and the Common Ocular Manifestations
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Abstract
Purpose
Ocular manifestations were reported in many recent observations that studied either the effect of COVID-19 directly on eyes or of face mask use. Hence, this study aimed to investigate the effect of COVID-19 on the eyes and make a clear comparison of its direct and indirect effect from face mask-wearing.
Methods
This was a cross-sectional study of both written and web-based questionnaires, distributed among a group of COVID-19 patients and a matched control group, the questionnaire consisted of common demographic data, COVID-19 infection history and its symptoms, focusing on ocular symptoms and the presence of conditions related to or cause eye symptoms. As well as the use of face masks that were assessed in terms of the complained ocular manifestation
Results
Of 618 participants, 252 had COVID-19 and 366 never had COVID-19. Ocular manifestation among COVID-19 incidence was 44%, significantly higher than non-infected participants’ incidence (35.8%), adjusted odds ratio, 95% confidence interval (AOR, 95%CI); 1.45 (1.02-2.06)). Eye discharges (p-value = 0.033) and photosensitivity (p-value = 0.003) were noted more commonly among COVID-19 participants compared to healthy control. When comparing long periods of face mask use with each ocular symptom; dry eye based on OSDI, forging body sensation, eye pain and eye discharges, were found significantly common among extended periods of face mask use.
Conclusion
COVID-19 pandemic affected eyes, both directly from the virus or from its preventive measure of face mask use.
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SciScore for 10.1101/2021.10.18.21265130: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: Before beginning the questionnaire, a request to declare voluntary consent was provided stating voluntary acceptance to participate, after describing the study and its objectives with ensuring the participants’ data privacy.
IRB: The study was approved to be in accordance with the Declaration of Helsinki by AL-Najah National University’ Ethics Committee.Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis Targeting a sample size of more than 226 for COVID-19 patients with a case: control ratio of 1:2, considering a 95% confidence interval and 90% power with an expected frequency of 18% vs 9% among COVID-19, general participants … SciScore for 10.1101/2021.10.18.21265130: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: Before beginning the questionnaire, a request to declare voluntary consent was provided stating voluntary acceptance to participate, after describing the study and its objectives with ensuring the participants’ data privacy.
IRB: The study was approved to be in accordance with the Declaration of Helsinki by AL-Najah National University’ Ethics Committee.Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis Targeting a sample size of more than 226 for COVID-19 patients with a case: control ratio of 1:2, considering a 95% confidence interval and 90% power with an expected frequency of 18% vs 9% among COVID-19, general participants respectively. (6,14,15) Participants who were older than 18 years and had COVID-19 within 6 months were recruited with a matched healthy control group. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:However, the study had many limitations, as it was based on a questionnaire, all results were subjective, and findings were not confirmed clinically, like by slit-lamp examination or Schirmer’s test. Additionally, its retrospective nature made it prone to recall bias, especially underestimating the ocular complaints incidence for considering eye manifestations are trifles, compared to other COVID-19 symptoms, though six months were chosen as recall memory would still be optimal. the control group had no tests as well, and so the possibility of someone having an asymptomatic COVID-19 was possible. But in both arms, symptoms of COVID-19 were investigated and the dilemmatic COVID-19 state cases were excluded. In conclusion, the COVID-19 pandemic had sequences that could even involve the eyes, causing irritations from the virus itself, and more broadly was responsible for the evolving of mask-associated dry eye, as part of its preventive measures. All of these should not be ignored and be considered when dealing with patients complaining of eye manifestations, and when need to wear masks for extended periods, lubricant or other methods would be suggested to avoid mask associated dryness.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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