By Marguerite McDonald, MD, FACS and Perry Fumuso, MS, MBA
No matter how long you operate a Dry Eye Center of Excellence, most of your dry eye patients will fit the classic mold: an older adult, usually over 50, and most likely a woman. Advancing age and being female will always be major risk factors for dry eye.
But we must never forget that a typical patient isn’t the only patient we’ll see.
Because these days, practices throughout the country are seeing younger and younger patients with classic dry eye symptoms, and ours is no exception.
The catalyst behind the shift is hardly a secret. It’s the same thing that has brought seismic change to virtually all areas of society over the last couple of decades: electronic devices.
We’re spending more and more time poring over smartphone, tablet, or computer screens – one 2016 study estimated we’re up to an average of 10 hours a day.1 And all that screen-time is drying younger and younger eyes. Why? The normal blink rate of 20 times a minute drops to three times a minute when one is using any digital device.
In our practice, we’re seeing significant numbers of college students and young professionals, often male, with dry eye. We are even seeing children as young as 10 or 12. Their reluctance to tear themselves away from their electronic devices, occasionally combined with allergy, asthma, or attention deficit hyperactivity disorder and the accompanying medications, has dried their eyes. I call this “situational” dry eye; the very young patients usually have no mechanical, hormonal, or medicinal risk factors like peri-menopausal women do. The only risk factor these young people have is their nearly non-stop use of electronic devices.
So, in short, as skill with digital devices is a key element for success in the modern world, dry eye is now—and will continue to be—an epidemic.
Between aging Baby Boomers and the increasing numbers of patients with Type 2 diabetes, dry eye numbers are certain to grow.
You can earn the gratitude and loyalty of all ages by offering, in addition to medication when necessary, some simple strategies to relieve chronic dry eye:
Lower your monitor. Position your computer monitor as low as possible, so that you’ll have to gaze downward. This forces the upper eyelids downward, so the interpalpebral distance is minimized, meaning less of the ocular surface is exposed. This leads to less evaporative tear loss.
Clear the air. Don’t blast the car heater or air conditioning directly into your face. Aim vents away from your face, and set the fan at the lowest speed possible.
Dodge the draft. If cold or hot air is blowing on you at work, close the vent, or, if possible, change your desk orientation or location. You can test this by holding a match exactly where your face is situated when you are seated at your desk (as long as there are no oxygen tanks nearby). If the flame flickers, you have a draft.
Use a humidifier. They’re especially essential if you live in a dry climate.
Live by the 20/20/20 rule while using your computer or digital device. Every 20 minutes, stand up for at least 20 seconds, and look at an object at least 20 feet away. This suggestion, created by the American Academy of Optometry, relaxes the ciliary body, allows the blink rate to return—however briefly—to normal, and is good for posture and circulation.
Portello JK, Rosenfield M, Chu CA. Blink rate, incomplete blinks and computer vision syndrome. Optom Vis Sci. 2013 May;90(5):482-7
Marguerite McDonald, MD, FACS, with OCLI on Long Island, NY, is clinical professor of Ophthalmology at NYU Langone Medical Center, NY, and clinical professor of Ophthalmology at Tulane University Health Sciences Center, New Orleans, Louisiana.