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June 2020
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Shelter in Place During COVID-19 and Dry Eye Disease
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Now that our practices are reopening, I am finding some very consistent findings with increase in dry eye symptoms that patients encountered while staying at home. Whether it was that they were working from home, or our patients who are retired and were in social isolation, they all had one thing in common. There was a tremendous increase in screen time. My patients that were working from home were tied to their computer and tablets with a combination of video meetings and retrieving and answering emails and performing their tasks online. They reported going from their laptops to their phones and spending some type of screen time at an ever-increasing pace with the demands of functioning remotely from their workplace. The dry eye symptomatic complaints of irritation as well as visual fluctuation have been common with many of my patients. Even those patients that are retired and self-isolating were reporting an inordinate amount of time on their computers.
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For all groups of patients, online shopping was the only means of acquiring non-essential items since many stores where closed down. It has made patients aware of the results of increasing screen time on the comfort of their eyes and it should also make us acutely aware that we need to pursue that information on all of our patients. It’s a digital world and we can see during this pandemic that many of our patients were affected by the increase in exposure created by light emitting devices and should be evaluated. It all starts with asking them questions of screen usage and correlating their symptoms.
We in turn should be much more proactive in prescribing treatment because it’s not a matter of if, but rather a matter of when they will be affected by their digital devices. An omega 6/3 supplement should be a prophylactic treatment recommended for all patients with no contraindications using digital devices, as well as prescribing quality warm compresses and lid hygiene for prevention. Our trigger should also be short to recommend a therapeutic eye medication for those patients spending time on digital devices that are symptomatic. In addition, checking for meibum function by diagnostically expressing patients will unveil problems early on. When we see early signs of changes in the meibum we should not hesitate to recommend thermal expression.
In short, patients have absolutely been able to correlate their visual comfort or lack thereof with the increase in screen time, and as their doctors, we should acknowledge the dangers and initiate treatment early to help prevent progression.
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Douglas K. Devries, OD has a degree in financial management from the University of Nevada and graduated from Pacific University College of Optometry. He is co-founder and managing partner of Eye Care Associates of Nevada. He is an adjunct clinical professor of optometry at Pacific University and residency program director. He dedicates the majority of his clinical practice to ocular surface disease.
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