Abstract

Dry eye syndrome and digital eye strain: diagnosis, treatment and management guidelines

Smart use of devices featuring digital screens is a key to the protection of eye health and good vision. Long-term work in front of screens in a poor working environment can cause various health problems. Patients with dry eye syndrome (DES) can experience more severe or new signs and symptoms, and many or even all of us are exposed to the risk of eye surface disorders due to screen time associated with the use of digital devices.

Currently, the diagnosis of DES is definitely based on the patient’s subjective assessment. Therefore, since we are practitioners, our diagnostic algorithm – DEWS II – is shifted towards the patient’s signs/complaints (sensation of burning, stinging or grit in the eye as well as eye dryness, hypersensitivity, discomfort, itching, rubbing, redness or pain) which are added to the existing pathway prior to triage questions under the applicable management procedure.

The quality of blinking is a critical element of the pathomechanism of DES and it should be evaluated during each visit. It is of particular importance to carry out an in-depth analysis of the eyelid margins, and to assess blink rate and the percentage of incomplete/partial blinks.

People working at a computer or doing other intense close visual work should remember to make breaks (the 20/20/20 rule) and to blink their eyes (completely and frequently) as well as to support the eye surface with eye drop substitutes and to clean the eye margins twice a day.

Any identified refractive errors and presbyopia need to be fully corrected – it is necessary to aid the visual/mental comfort.

We should never ignore the presence of chronic pain due to DES. Any differences in the distribution, type and strength of stimulation of and response from corneal receptors affect the psychosomatic profile of patients with eye surface disorders. In the author’s opinion, it is currently a crucial aspect as well as the most important trend in the approach to therapeutic management. Physicians should care about the comfort of life of their patients and show them empathy while being committed to providing treatment in line with evidence-based medicine.