Video display terminal use and dry eye: preventive measures and future perspectives

Abstract

Background Dry eye disease (DED) is a common cause of ocular pain and discomfort. Dry eye disease (DED) stems from a loss‐of‐tear film homeostasis and is frequently seen in video display terminal (VDT) users. Video display terminal (VDT) use reduces blink rates and increases incomplete blinks, leading to tear film instability and ocular inflammation, promoting DED. Purpose To assess and evaluate the methods for preventing VDT‐associated DED and ocular discomfort. Methods Studies were found using PubMed and Embase with the search terms: (digital visual terminal* OR computer use OR screen use OR smartphone OR display OR visual display terminal* OR computer vision syndrome OR tablet OR phone OR screen time) AND (dry eye OR DED). Results Thirty‐one relevant articles were found. Ten described single‐visit studies, whereas 21 had a prolonged follow‐up. Most preventive measures of VDT‐associated DED aimed to increase blink rate or directly prevent tear film instability, ocular inflammation, mucin loss or ocular surface damage. Using an adjustable chair and ergonomic training, blink animations and omega‐3 supplementation improved signs and symptoms of VDT‐associated DED. Taking frequent breaks was associated with fewer symptoms, but no study assessed the commonly suggested 20‐20‐20 rule. Conclusion Preventive measures, such as blink animation programmes, oral intake of omega‐3 fatty acids and improved ergonomics act on different parts of the vicious cycle of dry eye and could supplement each other. A comparison of the efficacy of the different interventions as well as more evidence of the effect of increased humidity, VDT filters and ergonomic practices, are required.

A Practical Approach to Severity Classification and Treatment of Dry Eye Disease: A Proposal from the Mexican Dry Eye Disease Expert Panel

“…For patients with excessive use of electronic devices with digital screens such as computers, tablets, and smartphones, we recommend increasing the administration of topical lubricants and applying the 20/20/20 rule (every 20 minutes, look away from the screen and focus the gaze on something at 20 feet for 20 seconds) to relax the accommodation reflex and reduce eye strain. 105 , 106 …”

Influence of Prolonged Visual Display Terminal Use on Physical and Mental Conditions among Health Care Workers at Tertiary Hospitals, Taiwan

“…Second, raising workers’ awareness of the ergonomics of their workstation (seat height adjustment, working desktop height, keyboard and mouse arrangement, screen contrast and brightness, and sight distance). Third, work organization (VTD working duration, rotation and shift job, job stress, and social support) [ 23 , 39 , 40 ], especially for women and younger workers.…”

“…Prevention of MSDs, visual symptoms, and mental health in hospitals an the organizational level consists of workplace risk assessment. The modifiable individual and work-related factors were as follows: improving health status, job satisfaction, reduction of working hours on VDTs, avoiding prolonged sitting and static postures, resting time during work hours, and performing regular daily exercises [ 7 , 8 , 9 , 10 , 23 , 39 , 40 ]. Thus, this research can help to protect HCWs in tertiary hospitals from the adverse effects associated with VDT work [ 6 ].…”

Effects on Ocular Dryness and Optical Quality when Watching Movies Using a Virtual Reality Device

“…On the other hand, there are different substitutes like aqueous supplementation or lipid supplementation and overnight treatments, depending on dry eye disease type. Likewise, blink animation programmes, Omega-3 fatty acids, and an ergonomic office space seem to be decreasing dry eye symptoms (24). A less used therapy is punctal occlusion which can be done temporarily or permanent.…”