Highlights
- •Digital screen exposure is known to adversely affect blink quality and frequency.
- •Blinking exercises are shown to modify poor blinking patterns.
- •Blinking exercises are shown to improve dry eye symptoms.
- •Blinking exercises result in changes in objective measures of tear film quality.
- •Consider incorporating a blink exercise routine into clinical care recommendations.
Abstract
Purpose
Dry eye disease (DED) is an important public health concern given its increasing prevalence
and impact on patient quality of life. Blinking frequency and completeness are reduced
during digital screen exposure, compromising meibum secretion and distribution, causing
tear film instability and leading to DED. This study evaluated the effects of blinking
exercises on blink pattern and clinical signs and symptoms of DED.
Methods
Fifty-four participants with dry eye symptoms received instructions to perform a ten-second
cycle of blinking exercises every 20 min during waking hours for four weeks. Symptoms
were assessed using the 5-item Dry Eye Questionnaire (DEQ-5) and Ocular Surface Disease
Index (OSDI); blinking patterns measured with the TearScience LipiView II; and tear
film and ocular surface parameters assessed with the Oculus Keratograph 5M. Measures
at baseline and on day 28 were compared.
Results
Forty-one participants completed the study, reporting an average of 25.6 daily blinking
exercise cycles. Improvements were noted in DEQ-5 (from 11 ± 4 to 7 ± 3; p < 0.001),
OSDI (36 ± 18 to 22 ± 17; p < 0.001), non-invasive tear film breakup time (6.5 ± 2.4
to 8.1 ± 4.8 s; p < 0.04), the proportion of incomplete blinks (54 ± 36 to 34 ± 29
%; p < 0.001), but not in tear meniscus height or tear film lipid layer thickness.
Conclusion
Blinking exercises can modify poor blinking patterns and improve dry eye symptomology,
with modest changes in objective measures of tear film quality. Incorporating such
routines into clinical care recommendations may improve blinking habits and help protect
against the impact of digital device use on tear film quality and DED onset and evolution.
Keywords
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Article info
Publication history
Published online: May 12, 2020
Accepted:
April 23,
2020
Received in revised form:
April 12,
2020
Received:
February 17,
2020
Identification
Copyright
© 2020 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
