Digital screen users may experience dry eye symptoms as a result of reduced blink rate and completeness. Photo: Getty Images.

Many studies have found digital screen use is associated with dry eye disease (DED), and as more people spend more time in front of digital screens, there is a higher likelihood that additional DED cases will arise throughout the world—more the reason why extensive research is necessary.

To further examine the relationship between digital screen use and DED, researchers recently conducted a search for articles that included information relevant to the association between dry eye and digital screen use, the association between dry eye and blinking dynamics, the impact of dry eye on quality of life of digital screen users and preventative strategies for dry eye in digital screen users.

The authors concluded that digital screen use influences blinking dynamics by reducing blink rate and completeness, which leads to increased ocular surface dryness.

“Aqueous tears evaporate from the tear film during the interval between each blink, and full blinking is required to replenish the tear film by distributing tears (from lacrimal glands) and lipids (from the meibomian glands) over the ocular surface,” the authors explained. “Thus, reduced and incomplete blinking results in ocular surface dryness because it allows for greater evaporative loss, which could, over time, potentially initiate the DED cycle. Interestingly, individuals who have dry eye typically blink more frequently than individuals without dry eye, which may be an attempt to compensate for tear film instability.”

Several studies support the hypothesis that blinking dynamics are altered during digital screen use, including one that found a mean rate of blinking in 104 office workers of 22 blinks per minute for a relaxed condition, 10 per minute while reading a book at a table and seven per minute while viewing text on a video screen.

“Similarly, blink rate has also been found to decrease during an active computer task (arranging words in alphabetical order) compared with the blink rate found when participants were engaged in relaxed conversation,” the authors explained.

Additionally, the percentage of incomplete blinks increases with active digital screen tasks. A previous study found the percentage of incomplete blinks increased compared with baseline during video games. Of the total blinks, 80% were incomplete in the baseline condition, whereas 92% and 88% were incomplete during video games.

“Therefore, prevention of DED may involve deliberately blinking the eyes and allowing the eyes time to blink naturally, as well as environmental modifications aimed at reducing tear evaporation,” the authors explained.

They suggest eye care professionals inquire about patients’ digital habits and dry eye symptoms during annual exams to help identify those at risk of DED and those who would benefit from a screening or evaluation for clinical signs of DED.

Al-Mohtaseb Z, Schachter S, Lee BS, et al. The relationship between dry eye disease and digital screen use. Clin Ophthalmol. 2021;(15):3811-20.