Increased digital screen usage, face masks, and winter weather combine to create a triple threat to eye health: the dry eye triad. This will combat the resulting eye fatigue, irritation and discomfort.
How do your eyes feel right now? Whether you are sitting at home or in the office, you are likely reading this on a digital device and your eyes can be hot, scratchy, tired, and dry. If so, you may be part of a new phenomenon called the dry eye triad (DET).
The science of dry eyes has advanced rapidly in recent years, as has general awareness of the condition. The researchers were faced with two new variables in the wake of the pandemic: significant increases in the use of digital screens and changes in airflow from wearing masks. Colder weather is looming in much of the world, adding a seasonal third blow to a growing problem.
The good news is that people don’t have to suffer in silence. As soon as you are aware of the causes and measures against drought, everyday comfort is usually within reach.
What is the dry eye?
Ophthalmologists report more patients with irritated, burning and stinging eyes. These symptoms are very common and, if the disease persists, can be diagnosed as dry eye, a condition that affects up to 75 percent of the population.
The severity varies, with most people experiencing mild intermittent symptoms, but for others, it can make work and daily life a bad thing.
Dry eye disease has many causes and in order to combat it effectively there are various aspects of eye health, general health, and the environment that need to be considered.
Starting with the eye itself, it was the job of an ophthalmologist like me to make sure the eyelids and eyelashes are healthy, that the glands in the eyelids are producing oils, that there are enough tears to keep the eye feel moist and to make sure that the Surface inflammation is controlled. It’s also important to consider health conditions and medications that can contribute to drying out the surface of the eye.
Then came the pandemic, behavior changed, and the dry eye triad began to affect millions of people around the world.
Factor 1: Influence of autumn and winter
Your eyes are subject to the same environmental conditions as the rest of your body. This is more evident in autumn and winter. As the surrounding air becomes less humid, dry eye symptoms increase. The pleasant humidity is usually between 40 and 70 percent. On the coldest winter days, the humidity can drop in the single digits. The tear film evaporates much faster under these conditions, which means that the surface of the eye remains drier than normal.
Cooler weather goes hand in hand with increased use of indoor heating. This usually dry heat accelerates the evaporation of the tear film even further.
Several steps can help to compensate for these drying situations. Using humidifiers increases the humidity, and air purifiers can also help.
Simple treatment strategies protect against excessive tear film evaporation by improving the oily (lipid) outer layer of the tear film. The use of warm compresses on the eyelids helps to distribute the tear film oils more easily, and the addition of artificial lipid-based tear drops complements the oil level.
It also helps to drink more water to maintain adequate fluid levels.
Factor 2: Increased use of digital devices
The COVID-19 pandemic has forced many people to work and study from home and spend more time with digital devices. When looking at a screen, dryness sensations are triggered by a change in the blinking pattern. Blinks are less frequent and not as full and complete.
The natural mechanism of blinking is important to distribute a fresh layer of tears on the surface of the eye. With a reduced blink rate, the tear film evaporates and is not replaced quickly enough, which leads to increased irritation and discomfort.
The simplest advice is to take more frequent breaks. The “20-20-20 rule” (looking at something 6 meters away every 20 minutes for 20 seconds) helps to manage eye strain when working on digital devices. There are even programs and apps that remind you to blink more often and more fully.
Factor 3: wearing a mask goes on
Since wearing masks indoors is still mandatory or recommended to reduce the spread of COVID-19, it has also resulted in some people noticing an increase in dry eye feelings. It is known as mask-related dry eye (MADE) and is caused by exhaled air flowing out of the top opening of the mask and over the surface of the eye, which causes the tears to evaporate even faster.
The remedy is similar to preventing glasses from fogging up when wearing a mask: Use medical tape to “seal” the top of the mask to prevent airflow.
Dealing with the dry eye triad
With winter approaching, the increase in the use of digital devices, and the wearing of masks, the three-layer threat to the stability of your tear film from dry eye is real. Fortunately, in most cases, that doesn’t have to be debilitating.
Start by talking to your eye doctor who can help you implement the steps I mentioned to make sure your eyes are lubricated, rested, and not exposed to low levels of humidity and evaporative air currents.
Severe dry eyes can definitely benefit from tailor-made treatment. Your optician or ophthalmologist can recommend a specific treatment regimen or refer you to a specialist dry eye clinic. Several new drugs and medical devices provide relief even in severe cases.
The most important advice of all, however, is not to ignore the dry eye entirely. The condition is real, more common than ever, and can be addressed with a combination of education, behaviors, and therapies. Understanding your options will put you on your way to comfortable, healthy eyes not just in the cold months but year round.
William Ngo is a consultant at Alcon and Sun Pharma. William Ngo is an independent contractor (optometrist) at Market Lane Optical. William Ngo is a volunteer for the American Academy of Optometry. William Ngo has received awards and research grants from the American Academy of Optometry Foundation. As employees of the Center for Ocular Research & Education (CORE), we have received research funding from the following companies: Alcon, Allergan, Allied Innovations, Aurinia Pharma, Azura Ophthalmics, Bausch Health Canada, Brien Holden Vision Institute, CooperVision, GL Chemtec, i-MED Pharma, Johnson & Johnson Vision, Lubris, Menicon, Nature’s Way, Novartis, Ophtecs, Ote Pharma, PS Therapy, Santen, SightGlass, SightSage, Visioneering Tech Inc.CORE has also received funding from the following funding organizations: American Academy of Optometry Foundation, Natural Sciences and Engineering Research Council of Canada, Canadian Institutes of Health Research, Mitacs, Canadian Association of Optometrists, European Union Funding for Research & Innovation, Canada Foundation for Innovation, Innovation and Technology Commission.