Baseline Dry Eye Symptoms Yield Even Greater Symptomatology During Computer Use

Businessman at desk in office rubbing his eyes
BARCELONA, SPAIN. At the office.
A study duration of only 30 minutes showed significant changes in dry eye symptoms following computer use, but the students enrolled in this study report using computers for an average 4.3±2.5 hours daily.

The presence of baseline dry eye symptoms is associated with an even greater increase in symptomatology following computer operation, according to a study published in Clinical and Experimental Optometry.

Researchers conducted a study of 82 students (mean age 22.8±2.1 years, 54 women) who use digital displays an average of 4.3±2.5 hours a day. They performed objective measurements including tear meniscus height (TMH), non-invasive keratograph breakup time (NIKBUT), conjunctival bulbar redness, meibomian gland dropout percentage, and percentage of incomplete blinks on all participants at the same time of day under identical environmental conditions. They also administered subjective analyses consisting of the ocular surface disease index (OSDI) questionnaire and the 5-item dry eye questionnaire (DEQ-5).

The team instructed participants to read the text of several stories for 30 minutes on a laptop computer. Viewing distance was 60 cm at approximately 10°, and text size met angular size for 0.15 logMAR visual acuity. Once the near-viewing computer task was complete, investigators repeated all measurements obtained at baseline.

With respect to objectively measured parameters, researchers noted that conjunctival bulbar redness and tear meniscus height increased, and NIKBUT decreased (0.52 to 0.58, P =.012; 0.23 to 0.28 mm, P <.0005; and 15.7 to 14.0 s, P =.003, respectively) following the completion of the computer activity.

A subjective analysis of both the OSDI and DEQ-5 revealed that dry eye symptoms were significantly higher following the computer task compared with baseline (P ≤.0005 for both). Researchers determined that baseline OSDI and DEQ-5 scores explained up to 31% of variability of the impact of computer use on dry eye symptoms (P <.005) and noted a negative association between change in NIKBUT and change in conjunctival redness (P =.006). More conjunctival redness and higher NIKBUT prior to the computer activity predicted a greater decrease in NIKBUT during the task (P =.005 and P <.005 respectively). 

Participants with increased DEQ-5 scores following computer use tended to experience significant increases in OSDI-5 (71.7% OR 6.34 P =.043). Individuals with a positive OSDI score at baseline that increased following the task were 15 times more likely to experience eye pain with computer operation (P =.02) and 11 times more likely to experience sore eyes during the task.

Most participants with increased OSDI-5 scores experienced increased light sensitivity, blurred vision, and poor vision throughout the task. Those who reported increases in OSDI and DEQ-5 scores were more likely to suffer increased eye discomfort.

“Reading on a computer for 30 minutes significantly increased dry eye signs and symptoms,” according to the researchers. “Several baseline and pre-task parameters were predictive of the impact of computer use on the ocular surface. Having greater symptoms of dry eye was predictive of a greater increase in symptomatology.”

Limitations of the study included lack of osmolarity measurements, small sample size, and single center design.


Talens-Estarelles C, García-Marqués JV, Cerviño A, et al. Ocular surface predisposing factors for digital display-induced dry eye. Clin Exp Optom. Published online March 7, 2022. doi:10.1080/08164622.2022.2048173