Correlation of Conjunctival Impression Cytology and Clinical Examination in University Students at Lahore during the COVID-19

Muhammad Saaed Zafar Khan, Javed Iqbal Qazi, Asad Aslam, Zahid Kamal, Ummara Rasheed

  • Muhammad Saaed Zafar Khan University of the Punjab
  • Javaid Iqbal Qazi Institute of Zoology University of the Punjab
  • Asad Aslam College of visual sciences, Kemu/ Mayo hospital Lahore
  • Zahid Kamal King Edward Medical University/ Mayo Hospital
  • Ummara Rasheed Statistician College of Ophthalmology and Allied Vision Sciences, KEMU Lahore
Keywords: Video Device Terminal, Computer Vision Syndrome, Conjunctival Impression, Cytology, Tear Function Tests


During COVID 19 pandemic every home-bound school, college, and university student was using computers and electronic gadgets for social networking and online education. To assess the effects of these gadgets on ocular and vision-related problems, very little research had been done on the Pakistani population, especially among university students. An analytical cross-sectional study was carried out on 355 students of University of the Punjab. Questionnaire-based data were collected by measurement of tearfilm breakup time(TBUT), the number of corneal dry spots, Schirmer’s test, and conjunctival impression cytology(CIC). Pearson correlation analysis was done on CIC score versus TBUT, Schirmer’s test and Goblet Cell Density (GCD). Analysis of variance (ANOVA) was used for mean comparison of visual acuity, TBUT, cornea spots, and Schirmer’s test to see the significance of the results. P-value≤0.05 was considered statistically significant. Out ofthe 355 students, 65% were females. The mean age of the students was 22.30 ± 6.8 years. At each level of visual acuity, there was no statistically  significant difference between the meansof the different levels of visual acuity (F=0.488, p=0.614). A statistically significant meandifference was found between CIC score and TBUT (F=208.45p=<0.001), CIC score andcornea spot (F=39.31, p=<0.001), CIC score and Schirmer’s test (F=5.83, p=0.001). Forthe early diagnosis and management of CVS, in addition to applying the validated questionnaire and clinical dry eye tests, the Conjunctival impression cytology can be tested on a larger population to be proven as a gold slandered test.