Most teens and young adults are not aware that the visual discomfort they experience from staring at digital device screens may be symptoms of dry eye. They are not aware of the window of opportunity to receive preventative interventions through their eye doctor that may reduce the risk of progression to dry eye disease. While we cannot blame dry eye entirely on our incessant use of digital screens, doctors report more young patients of younger ages (even teens) presenting with dry eye symptoms of meibomian gland dysfunction, which they attribute at least in part to increased screen time (average eight hours daily) and contact lens wear.

In the Ageing and the Natural History of Dry Eye Disease, a prospective registry-based cross-sectional study, findings show: “…that each decade of life is, on average, associated with 24 percent increased odds of developing dry eye disease.” In the study, signs of meibomian gland dysfunction emerged earlier in the natural history of disease progression, with the optimal prognostic cut-off ages for gland dropout, diminished meibum expressibility and reduced tear film lipid layer quality occurring in the third decade of life, between 24 and 29 years of age; the optimal predictive ages for lid wiper epitheliopathy, tear film instability, hyperosmolarity and dry eye symptoms occurred during the fourth decade of life (31 to 38 years); while the optimal prognostic thresholds for signs of aqueous tear deficiency and ocular surface staining occurred in the fifth and sixth decades of life (46 to 52 years). Signs of meibomian gland dysfunction appeared earlier in the natural history of disease progression, and the brief delay prior to the development of other clinical dry eye signs might represent a window of opportunity for preventative interventions in the young adult age group.

Early detection and treatment, and protective/preventative measures can prevent decades of exposure to environmental and physiological insults that cause oxidative stress of the ocular surface and tear film, disrupting normal basal tear production and tear film stability. Dry eye disease (DED) is a multifactorial degenerative, progressive disease of the tears and ocular surface. Tear film instability leads to visual discomfort and loss of visual clarity. With age, we experience a decline in our protective tear proteins and enzymes that prevent damage from pollutants, ultraviolet radiation and other recognized threats such as ozone and chronic use of preserved eyedrops to treat glaucoma, according to researchers Sophia Seen and Louis Tong in their research paper titled “Dry Eye Disease and Oxidative Stress.” The authors of the study state: “…an imbalance between the level of reactive oxygen species (ROS) and the action of protective enzymes will lead to oxidative damage and possibly inflammation.” Oxidative stress is exacerbated by our body’s natural decline in antioxidants needed to combat oxidative stress.

We can do our part by making sure every young adult patient and parent of teenagers is aware that dry eye can be more than discomfort, it can progress to dry eye disease. Make them aware that there is a window of opportunity for teens and young adults through early intervention to reduce the risk of developing dry eye disease.


Deborah Kotob
Pro to Pro Director
[email protected]