Ocular surface predisposing factors for digital display-induced dry eye

ABSTRACT

Clinical relevance

The use of digital displays is recognised as a consistent risk factor for dry eye disease.

Background

To identify ocular parameters contributing to the impact of computer use on dry eye.

Methods

The ocular surface of 82 undergraduate students with a mean age of 22.8 ± 2.1 years was assessed at baseline and after reading on a computer for 30 minutes. Measurements included the ocular surface disease index (OSDI) questionnaire, 5-item dry eye questionnaire (DEQ-5), tear meniscus height, non-invasive keratograph break-up time (NIKBUT), conjunctival bulbar redness, meibomian gland dropout percentage, spontaneous blink rate and percentage of incomplete blinks. Multiple linear regressions and generalised linear mixed models were conducted to explore the associations between baseline parameters and pre-task – post-task differences and to predict the impact of computer use, respectively.

Results

Greater dry eye symptoms (p < 0.0005), higher tear meniscus height and conjunctival bulbar redness (p < 0.0005 and p = 0.012, respectively) and shorter NIKBUT (p = 0.03) were obtained after reading on the computer for 30 minutes. The baseline score obtained with the OSDI and DEQ-5 was positively associated with the increase in symptoms with computer use (p < 0.0005), while the change in conjunctival redness and pre-task NIKBUT were associated with the change in NIKBUT (p ≤ 0.005). No ocular surface parameter revealed an association with tear meniscus height changes. Having a positive OSDI score at baseline increased the odds of painful and sore eyes (p = 0.012), while a higher pre-task NIKBUT increased the odds of a reduction in tear stability (p = 0.038).

Conclusions

Participants with greater dry eye symptoms were more likely to experience a greater increase in symptomatology with computer operation, while the participants with longer NIKBUT and greater conjunctival redness were more likely to suffer a greater reduction in tear stability.

KEYWORDS:

• Dry eye
• digital displays
• ocular surface
• spontaneous blinking
• tear film

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Ministerio de Educación, Cultura y Deporte (Spain) [grant number FPU17/03665]; the ‘Conselleria d’Educació, Investigació, Cultura i Esport de la Generalitat Valenciana’ [grant number GV/2018/059]; and the University of Valencia [grant number UV-INV-PREDOC18F2-886420].