Dry Eye Diseases (DED)

Common causes of Dry Eye Disease (DED)

• Too much (more than 6 hours a day) exposure to digital screens- Mobile, Computer/Laptop, TV, Tablet, Kindle – Computer vision syndrome (CVS)/Digital Strain – Can be a professional hazard
• Office environment- Air conditioning, Low humidity
• Air pollution and allergy
• Contact lens use -abuse
• Associated with certain systemic diseases like thyroid, hormone fluctuation, RH etc.
• Associated with some systemic medications
• Eye make-up- abuse
• Some of the eye surgeries and eye medications
• Associated with Lid margin diseases/problems

COMPUTER VISION SYNDROME (CVS)/DIGITAL STRAIN/DRY EYE

Definition:

Computer Vision Syndrome, also referred to as Digital Eye Strain, describes a group of eye and vision-related problems that result from prolonged computer, tablet, e-reader, and cell phone use

Etiological Factors:

• Decreased blinking
• Continuous work without break
• Seating posture- poorly supported head and neck
• Illumination at the work place
• Glare on the screen
• Combination of these factors

SYMPTOMS:

• Foreign body sensation
• Gritty sensation
• Irritation
• Burning
• Watering
• Dry eye
• Itching
• Glared or blurred or shaky vision
• Tired &/or sleepy eye
• Deep socket pain or pulling sensation in eye
• Headache
• Red eye

Patient can have any one of them or multiple of them, either in one eye or both eyes. Also, patient can have good day or bad day.

TREATMENT OF CVS:

• Lubricating Drops- ideally should be continued for couple of weeks as Dryness takes some time to settle down
• Education about good habits while working on digital screen
• Medications to improve Tear film production- when dry is associated with some other factors also

GOOD HABITS WHILE WORKING ON COMPUTER:

• Location of computer screen – The computer screen should be 15 to 20 degrees below eye level (about 4 or 5 inches) as measured from the center of the screen and 20 to 28 inches from the eyes
• Reference materials – These materials should be located above the keyboard and below the monitor or document holder can be used beside the monitor
• Blinking – make an effort to blink frequently. Blinking helps to make healthy tear film and keeps the front surface of your eye moist by spreading over the eye
• Rest breaks – 20-20-20 – every 20 minutes look at the distance of 20 feet for 20 seconds- frequent breaks are very crucial to provide rest to your accommodative muscles which helps you to focus at near objects
• AC breaks- Rest your eyes for 15 minutes after 4-6 hours of continuous computer use
• Lighting – Position the computer screen to avoid glare, use blinds or drapes on windows and replace the light bulbs in desk lamps with bulbs of lower wattage
• Anti-glare screens – If there is no way to minimize glare from light sources, consider using a screen glare filter which decrease the amount of light reflected from the screen
• Blue filter glass to protect your eyes from harmful rays from digital screen
• Seating position – Chairs should be comfortably padded and adjusted to rest your feet flat on the floor. Chair arms adjusted to provide arm support while you are typing. Support to your wrists when typing
• Cold compression over lid margin

 

OTHER TREATMENTS FOR DRY EYE

• Eyelid margin diseases, generally are chronic diseases, require thorough, long-term treatment
• Lid margin hygiene- regular thorough cleaning of Lid margin/Eyelashes- is very important, as recurrence is very high
• Warm compression over lid margin in case of Lid margin diseases. Even devices are available for home warm compressions
• Advanced cases – Lid Laser Therapy (like Lipi flow)
• Taking care of Systemic Diseases like Thyroid disease, Rheumatoid Disease etc.

 

CHILDREN AND DIGITAL SCREEN:

• Current evidence shows that digital media differ in their impacts on cognition, psycho-social function, and physical health, and that benefits and risks are nuanced
• ‘Screen time’ refers to time spent with any screen, including smart phones, tablets, television, video games, computers, or wearable technology
• There is a world-wide epidemic of Myopia, also known as Nearsightedness. Clearly, something is going on, but scientists cannot agree on exactly what are the reasons. Though many strongly attribute it to rising exposure to digital screen and less outdoor activity.
• Many studies suggest that at least part of the worldwide increase in nearsightedness has to do with near work activities; not just digital screen time but also traditional books
• Also, it is recommended that spending time outdoors—especially in early childhood—can slow the progression of nearsightedness, though exact reasons are still unclear
• Kids also get digital eyestrain like adults. They can experience dry eye, eye strain, headaches, and blurry vision, too. While symptoms are typically temporary, they may be frequent and rarely persistent.

 

Tips to help protect your child’s eyes from computer eyestrain:

• Set a kitchen timer or a smart device timer to remind them.
• Alternate reading with an e-book and with a real book.
• Encourage kids to follow 20-20-20 rule. Every 20-30 minutes, look up and far at 20 feet distance, for 20 seconds.
• Pre-mark books with a paperclip every few chapters to remind your child to look up. On an e-book, use the “bookmark” function for the same effect.
• After completing a level in a video game, look out of the window for some time or do some other activity.
• Avoid using a computer outside or in brightly lit areas, as the glare on the screen can create strain. Room should not be too bright or dark.
• Adjust the brightness, contrast, and color temperature of computer screen so that it feels comfortable to the eyes
• Use good posture while using a computer, and while reading
• Encourage your child to hold digital media farther away, 18 to 24 inches is ideal
• Create a distraction that causes your child to look up every now and then
• Remind them to blink while watching a screen
• Encourage the child for outdoor activity, everyday
• At least 2 hours before going bed stop usage of all digital screens, but Child can read the books