Review on the possible pathophysiological mechanisms underlying visual display terminal‐associated dry eye disease

Abstract

Background: Visual display terminal (VDT) use is a key risk factor for dry eye disease (DED). Visual display terminal (VDT) use reduces the blink rate and increases the number of incomplete blinks. However, the exact mechanisms causing DED development from VDT use have yet to be clearly described. Purpose: The purpose of the study was to conduct a review on pathophysiological mechanisms promoting VDT-associated DED. Methods: A PubMed search of the literature investigating the relationship between dry eye and VDT was performed, and relevance to pathophysiology of DED was evaluated. Findings: Fifty-five articles met the inclusion criteria. Several pathophysiological mechanisms were examined, and multiple hypotheses were extracted from the articles. Visual display terminal (VDT) use causes DED mainly through impaired blinking patterns. Changes in parasympathetic signalling and increased exposure to blue light, which could disrupt ocular homeostasis, were proposed in some studies but lack sufficient scientific support. Together, these changes may lead to a reduced function of the tear film, lacrimal gland, goblet cells and meibomian glands, all contributing to DED development. Conclusion: Visual display terminal (VDT) use appears to induce DED through both direct and indirect routes. Decreased blink rates and increased incomplete blinks increase the exposed ocular evaporative area and inhibit lipid distribution from meibomian glands. Although not adequately investigated, changes in parasympathetic signalling may impair lacrimal gland and goblet cell function, promoting tear film instability. More studies are needed to better target and improve the treatment and prevention of VDT-associated DED.

Prevalence of Dry Eye Symptoms and Associated Risk Factors among University Students in Poland

“…Previous research has identified many risk factors for DED, including aging, female sex, Asian race, environmental exposures, autoimmune diseases, allergies, hormonal imbalance, psychiatric disorders, certain classes of medications, contact lens wear, refractive surgery, and so on [2,3,10]. However, the extended use of digital display terminals (DDTs), such as computers, smartphones, or tablets, is considered to be a key risk factor for DED, mainly through impaired blinking patterns [11].…”

Relationship between visual display terminal working hours and headache/eyestrain in Korean wage workers during the COVID-19 pandemic: the sixth Korean Working Conditions Survey

“…Unlike previous studies, this study classified working hours into daily VDT working hours and weekly total working hours to investigate the risk of headache/eyestrain. 3 37 38 In a study that investigated 721 wage workers, the ORs for severe or disabling headache among individuals working ≥ 55 hours a week, compared with those working between 35 and 45 hours a week, were 1.38 and 1.63, respectively. 39 In other words, the longer the weekly total working hours, the higher the risk of headaches due to repetitive contraction of the neck and shoulders.…”

Can Nutrition Play a Role in Ameliorating Digital Eye Strain?

“…While the pathophysiology extends beyond the scope of the present review, it is important to briefly discuss the various contributing factors as they relate to the ability of nutrition in ameliorating symptoms associated with digital eye strain [ 6 , 44 , 49 , 57 ]. A number of excellent reviews which have discussed several putative mechanisms in more detail along with the spectrum of physiological effects can be found elsewhere [ 4 , 5 , 6 , 8 , 46 , 54 , 58 , 59 ].…”

“…Symptoms often range from irritation, burning, and stinging, as well as epiphora and foreign body sensations [ 63 , 64 ]. It has been well-documented that greater screen time behaviors represent a major component in developing symptoms of dry eye, often associated with lacrimal gland dysfunction and signs of evaporative dry eye disease [ 3 , 27 , 44 , 58 , 60 , 61 , 62 , 65 , 66 , 67 , 68 ]. In particular, computer usage significantly influence various dynamics of blinking patterns (such as frequency, amplitude, and complete vs. incomplete) thereby further increasing the rate of evaporation and exacerbating tear film instability [ 18 , 23 , 54 , 58 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 ].…”

“…It has been well-documented that greater screen time behaviors represent a major component in developing symptoms of dry eye, often associated with lacrimal gland dysfunction and signs of evaporative dry eye disease [ 3 , 27 , 44 , 58 , 60 , 61 , 62 , 65 , 66 , 67 , 68 ]. In particular, computer usage significantly influence various dynamics of blinking patterns (such as frequency, amplitude, and complete vs. incomplete) thereby further increasing the rate of evaporation and exacerbating tear film instability [ 18 , 23 , 54 , 58 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 ]. The combination of sub-optimal tear production and excessive evaporation can lead to tear hyperosmolarity with subsequent inflammation of the epithelial surface [ 76 , 77 , 78 , 79 , 80 ].…”