Dry Eyes, Computer Screens, and Meibomian Gland Dysfunction (MGD)

Dry eyes from computer and phone useDry eyes are among the most prevalent issues reported by our customers and patients. Women experiencing perimenopause and menopause frequently have dry eyes. However, it is increasingly observed across all age groups, largely attributable to prolonged use of digital devices such as computers, laptops, tablets, and smartphones. 1 2 This extended screen time alters blinking patterns over time and exposes us to environmental pollutants, contributing to the development of dry eye symptoms and meibomian gland dysfunction.

How Prevalent is Dry Eye Syndrome?

A systematic review and meta-analysis found that in three studies representing the US population, the combined prevalence of dry eye was 8.1% (with a 95% prediction interval of 0%-98.9%). Additionally, the pooled prevalence of meibomian gland dysfunction (MGD) was 21.2% (with a 95% prediction interval of 0%-100%) across the same three studies. The incidence of dry eye ranged from 3.5% to 7.8% in the included research.3

Screentime Can Lead To Dry Eye

The widespread popularity of video games has led to individuals spending an average of at least one hour per day playing them. A study examining the effects of video game playing observed alterations in tear quality, including a decrease in tear meniscus height, reduced tear breakup time, an increase in tear breakup area, and changes in the interference patterns of the lipid layer.4

One common idea is that looking at digital screens can cause dry eyes by affecting how often we blink. Several studies support this, showing that people blink differently when using digital screens. 5 6 For example, when doing tasks on a computer, like organizing words alphabetically, people tend to blink less compared to when they’re having a relaxed conversation. 7

Office Workers And Blink Rates

Early research by Tsubota and Nakamori found that office workers blinked at a rate of 22 times per minute when relaxed, 10 times per minute while reading a book, and only 7 times per minute when looking at text on a video screen. This suggests that the blink rate decreases when using digital screens, which may contribute to dry eyes. 8

Schoolchildren and Smartphones

Research indicates that school-age children with dry eye disease tend to spend more time using smartphones than those without the condition. For instance, a study conducted in 2020 involving 9- to 10-year-old children revealed that they spent an average of 3.8 hours per day engaged with screens, including activities like watching TV, videos, playing video games, texting, chatting, and using social media. Almost all children reported using screens daily, 9 a trend that further intensified during the COVID-19 pandemic when children stayed at home, relying on computers for both educational and personal purposes.10 11

Dry Eye Causes and Effects

Dry eye disease (DED) is characterized by instability in the tear film and inflammation, potentially causing damage to the ocular surface. 12 Symptoms of DED vary from person to person and can range from mild discomfort to more severe issues such as blurry vision, eye pain, and fatigue.13 14 Additionally, DED may lead to difficulties in reading and driving, 15 16 17 impact mental health, 18 and reduce work productivity.19 20 Other symptoms include photophobia, stinging, burning, itching, and irritation. 21 Without proper treatment, DED can progress to corneal damage, particularly in chronic cases where tears fail to lubricate the eyes adequately.

Meibomian gland dysfunction (MGD) is a common contributor to dry eye syndrome, occurring when the oil-secreting glands in the eyelids fail to produce sufficient or high-quality oil necessary to prevent eye dryness. These glands, known as the meibomian glands, play a crucial role in providing essential lubrication for the eyes.

Causes of Tear Instability

Various factors can contribute to tear instability, including insufficient tear production or poor tear quality, leading to inflammation and damage to the eye’s surface.

Individuals with dry eyes often experience discomfort, such as stinging or burning sensations. Dry eye symptoms can be triggered by specific environments, such as airplanes, air-conditioned rooms, or prolonged computer screen use. Additionally, activities like biking can exacerbate dry eye symptoms.

Additional factors associated with dry eyes include advancing age, being female, the presence of eye disease, and specific systemic or autoimmune conditions. 22 External influences also contribute to dry eye symptoms. For example, regular contact lens usage, certain medications, and cosmetics (especially non-organic products). Also, low humidity and air blowing directly on the eyes are drying. 23 24

Preventing and Managing Dry Eyes

At Natural Eye Care, we have a long list of techniques for preventing and managing dry eye.

Take Breaks: To safeguard your vision and minimize the likelihood of developing dry eye disease (DED), take regular breaks from computers and other digital devices. One effective strategy is to follow the 20-20-20 rule: every 20 minutes of screen time, take a 20-second break to focus on an object approximately 20 feet away.

Do eye exercises at intervals throughout the day. Download our free eye exercise ebook for instructions. The ebook also covers specific acupressure points to massage.

Counteract dry air. Environmental adjustments can also be beneficial. For instance, if you’re working in a dry setting, consider installing a humidifier to maintain optimal moisture levels.

Reduce glare when looking at screens. Position the computer screen to minimize reflections from overhead lighting or windows. Attach an anti-glare filter or screen protector to the computer monitor. Dim the overhead lighting. Use window coverings to block direct sunlight from entering the room.

Adjust your computer settings. Enlarge the font sizes. Set the brightness and contrast to levels that are comfortable for your eyes. Lowering the brightness can help reduce glare, especially in low-light conditions.

Get your glasses checked. Ensuring your eyeglass prescription is up-to-date is essential for optimal vision and eye comfort. Wearing glasses with anti-reflective coatings can help reduce glare from the computer screen and ambient light sources.

Blink. When looking at a screen, remind yourself to blink frequently. When taking a break, try squeeze blinking. Squeeze blinking is a deliberate and thorough blinking action that involves closing the eyelids tightly together and then reopening them. Your eyelids will come into contact with each other, spreading tears evenly across the surface of the eye. This lubricates and moisturizes the eyes, reducing dryness and discomfort.

Apply moist heat. If your eyes are dry, purchase a moist heat mask for the eyes and follow package directions. Afterward, clean your eyelid margins with pre-packaged eyelid wipes or baby shampoo (see directions).

Use artificial tears when you have dry eye symptoms. Check the label for a preservative-free formula in a bottle or individual packets.

Visit the eye doctor if you are concerned about dry eye symptoms. Your ophthalmologist may suggest a prescription eye drop, silicone plugs, or other techniques to combat dry eye.

Supplements to Consider

Dry Eye Formulas

Tear Stimulation Forte Homeopathic Eyedrops 10ml per Bottle

Women’s Tear Stimulation Dry Eye Homeopathic Eyedrops 10ml per bottle

OPTASE® Dry Eye INTENSE Drops (.33fl. oz.)

Dr. Grossman’s Omega-7 Chronic Dry Eye and Anti-Inflammatory Formula

Dr. Grossman’s Dry Eye and Tear Film Support Formula

Eye Supplements

Advanced Eye & Vision Support Formula (whole food) 60 vcaps – this is our whole food, organic, GMO free foundation eye formula.

Dr. Grossman’s Meso Formula Optimal Ocular Health in Digital Age – 90 vcaps

Retinal Support (wild-crafted herbal formula) 2 oz

Dr. Grossman’s Whole Food Organic Superfood Multi-Vitamin 120 Vcaps – this is our whole food, organic, GMO free formula

NMN Wonderfeel Capsul 60 vegcaps

Nitric Oxide Supplement

Allergy, Cold, and Flu Formulas

Jason’s Famous Respiratory Defense, formerly Cold & Flu Formula 2oz

Allergy Desensitization Homeopathic Eye Drops 10ml per bottle

Optase Allegro (allergy) Dry Eyedrops

Books to Read

Natural Eye Care: Your Guide to Healthy Vision and Healing

Natural Brain Support: Your Guide to Preventing and Treating Alzheimer’s, Dementia, and Other Related Diseases Naturally

Natural Parkinson’s Support: Your Guide to Preventing and Managing Parkinson’s

Related Health Conditions

Sjogren’s Syndrome and other autoimmune diseases

Corneal Diseases such as keratoconus and bullous keratopathy, and Fuch’s Corneal Dystrophy.

  1. Stapleton F, Alves M, Bunya VY, et al. TFOS DEWS II epidemiology report. Ocul Surf. 2017;15(3):334–365.
  2. LeBlanc AG, Gunnell KE, Prince SA, Saunders TJ, Barnes JD, Chaput J-P. The ubiquity of the screen: an overview of the risks and benefits of screen time in our modern world. Transl J Am Sports Med. 2017;2(17):104–113.
  3. McCann P, Abraham AG, Mukhopadhyay A, et al. Prevalence and Incidence of Dry Eye and Meibomian Gland Dysfunction in the United States: A Systematic Review and Meta-analysis. JAMA Ophthalmol. 2022;140(12):1181–1192. doi:10.1001/jamaophthalmol.2022.4394
  4. Cardona G, Garcia C, Seres C, Vilaseca M, Gispets J. Blink rate, blink amplitude, and tear film integrity during dynamic visual display terminal tasks. Curr Eye Res. 2011;36(3):190–197. doi: 10.3109/02713683.2010.544442
  5. Ibid.
  6. Acosta MC, Gallar J, Belmonte C. The influence of eye solutions on blinking and ocular comfort at rest and during work at video display terminals. Exp Eye Res. 1999;68(6):663–669. doi: 10.1006/exer.1998.0656
  7. Freudenthaler N, Neuf H, Kadner G, Schlote T. Characteristics of spontaneous eyeblink activity during video display terminal use in healthy volunteers. Graefes Arch Clin Exp Ophthalmol. 2003;241(11):914–920. doi: 10.1007/s00417-003-0786-6
  8. Tsubota K, Nakamura S. Dry eyes and video display terminals. N Engl J Med. 1993;328(8):584. doi: 10.1056/NEJM199302253280817
  9. Walsh JJ, Barnes JD, Tremblay MS, Chaput J-P. Associations between duration and type of electronic screen use and cognition in US children. Comput Human Behav. 2020;108:106312. doi: 10.1016/j.chb.2020.106312
  10. Vanderloo LM, Carsley S, Aglipay M, Cost KT, Maguire J, Birken CS. Applying harm reduction principles to address screen time in young children amidst the COVID-19 pandemic. J Dev Behav Pediatr. 2020;41(5):335–336. doi: 10.1097/DBP.0000000000000825
  11. Hussaindeen JR, Gopalakrishnan A, Sivaraman V, Swaminathan M. Managing the myopia epidemic and digital eye strain post COVID-19 pandemic – What eye care practitioners need to know and implement? Indian J Ophthalmol. 2020;68(8):1710–1712. doi: 10.4103/ijo.IJO_2147_20
  12. Craig JP, Nichols KK, Akpek EK, et al. TFOS DEWS II definition and classification report. Ocul Surf. 2017;15(3):276–283. doi: 10.1016/j.jtos.2017.05.008
  13. Clayton JA. Dry eye. N Engl J Med. 2018;379(11):e19.
  14. Kawashima M, Yamatsuji M, Yokoi N, et al. Screening of dry eye disease in visual display terminal workers during occupational health examinations: the Moriguchi Study. J Occup Health. 2015;57(3):253–258. doi: 10.1539/joh.14-0243-OA
  15. Stapleton F, Alves M, Bunya VY, et al. TFOS DEWS II epidemiology report. Ocul Surf. 2017;15(3):334–365.
  16. Karakus S, Mathews PM, Agrawal D, Henrich C, Ramulu PY, Akpek EK. Impact of dry eye on prolonged reading. Optom Vis Sci. 2018;95(12):1105–1113. doi: 10.1097/OPX.0000000
  17. Mathews PM, Ramulu PY, Swenor BS, Utine CA, Rubin GS, Akpek EK. Functional impairment of reading in patients with dry eye. Br J Ophthalmol. 2017;101(4):481–486. doi: 10.1136/bjophthalmol-2015-3082
  18. Paulsen AJ, Cruickshanks KJ, Fischer ME, et al. Dry eye in the Beaver Dam Offspring Study: prevalence, risk factors, and health-related quality of life. Am J Ophthalmol. 2014;157(4):799–806. doi: 10.1016/j.ajo.2013.12.023
  19. Nichols KK, Bacharach J, Holland E, et al. Impact of dry eye disease on work productivity, and patients’ satisfaction with over-the-counter dry eye treatments. Invest Ophthalmol Vis Sci. 2016;57(7):2975–2982. doi: 10.1167/iovs.16-19419
  20. Uchino M, Uchino Y, Dogru M, et al. Dry eye disease and work productivity loss in visual display users: the Osaka Study. Am J Ophthalmol. 2014;157(2):294–300. doi: 10.1016/j.ajo.2013.10.014
  21. van Tilborg MM, Murphy PJ, Evans KS. Impact of dry eye symptoms and daily activities in a modern office. Optom Vis Sci. 2017;94(6):688–693. doi: 10.1097/OPX.0000000000001086
  22. Ibid, Stapleton F, Alves M, Bunya VY, et al.
  23. Gomes JAP, Azar DT, Baudouin C, et al. TFOS DEWS II iatrogenic report. Ocul Surf. 2017;15(3):511–538.
  24. Jones L, Downie LE, Korb D, et al. TFOS DEWS II management and therapy report. Ocul Surf. 2017;15(3):575–628