Are you unable to look at the screen when you work from home? More new patients have been referred to the Singapore National Eye Centre (SNEC) for dry eye disease amid the Covid-19 pandemic – with mask-wearing, stress and lack of sleep also contributory factors.
Professor Louis Tong, senior consultant at its corneal and external eye disease department, said SNEC saw 323 new referrals last year – about a 15 per cent increase from 281 in 2019, prior to the pandemic.
Of the 323, 76 were below the age of 50, and of those, 47 were younger than 40 – up from 39 in 2019.
He explained that while dry eyes can be described as a broad umbrella term that covers a wide range of conditions, most sufferers experience one or more of the following symptoms: irritation of the eyes, intermittent blurred vision and tired eyes.
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About 90 per cent of those with dry eye disease fall into this group, and can be considered to have community dry eye disease – a less severe form of the condition, said Prof Tong, who is also principal clinician scientist and head of the ocular surface research group at the Singapore Eye Research Institute.
The remaining 10% have a more severe form of the disease. It can cause eye damage such as loss or vision impairments.
Although it is not common for this to lead blindness, Prof Tong said that patients suffering from visual disability can find it difficult to work, drive, or wear contact lenses.
He said that patients with medically significant dry eyes often develop after undergoing multiple eye operations, bone marrow transplants, autoimmune diseases, or long-term use of glaucoma drops.
He said that there are many other factors that can contribute to dry eye disease in the community, such as hormonal issues, ageing, vitamin deficiency, and a lack of exercise.
The pandemic has also made three other factors more common, which is why there was a large increase in referrals. One is related to increased time spent staring at screens as a result of work-from-home arrangements.
“You tend to blink a lot less when you’re using a computer or staring at something intensively… if you reduce blinking, that means your eyes are exposed to the air for a longer time,” said Prof Tong, adding that blinking helps lubricate the eyes and prevent a build-up of oil in the glands of the eye.
Face masks are becoming more popular. “When you wear a mask, the airflow goes above the mask and hits the eyes, so they dry up a lot more,” said Prof Tong.
Third, the pandemic has resulted in more stress and less sleep. Sleep is important as it reduces the amount of time a person’s eyes are exposed to the drying air.
He added that apart from the uncomfortable symptoms mentioned earlier, dry eye disease can impact people’s jobs and their ability to do things like drive at night.
It can also impact your mental health.
Sharon Sung (mental health expert and assistant professor at Duke University-NUS Medical School’s signature program in health services research and systems analysis) stated that depression and anxiety rates in adults with dry eyes are approximately three times higher than in those without.
“Dry eye disease itself can lead to difficulties with sleep and reduced quality of life due to interference in daily activities,” she added. She pointed out that people may feel more anxious or depressed if they are feeling depressed. This can make it harder to cope with the disease.
Prof Sung said that cognitive behavioural therapy and other treatments may be able to help patients with dry eyes disease cope. Doctors and optometrists need to ask such patients about their moods and sleeping habits, stress levels and quality of living.
“Treating the whole person is important to achieving the best outcomes for both physical and mental well-being,” she added.
Ms Juliana Ang has lived with dry eyes disease since 1992. Ms. Juliana Ang, deputy director of human resource, said that she experiences pain in her eyes, blurry vision, and sometimes discharges from her corner.
Fluorescent lights can cause severe damage to her eyes. She must wear sunglasses while driving.
“You feel like there’s something in your eye which you can’t remove. You keep rubbing it and try to get water to flush it out, but that makes it worse,” she said.
Prof Tong stated that for most patients, the condition can still be managed without visiting a doctor. He suggested steps like getting more sleep, exercising, using an eye-warming masque regularly, and applying eye drops before looking at a screen.
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He said that even if someone doesn’t have the condition, it can be done to reduce the chance of developing it.
If someone experiences dry eyes and their condition does not improve, they should seek medical attention.
Medical professionals can take further action such as prescribing medication and special eye drops, or inserting tiny plugs in the eye’s tear ducts – but the problem may never go away completely.
Prof Tong added: “Your body is naturally optimised to take care of your eyes, so take care of your body before it’s too late.”
Ms Ang manages her condition by applying eye drops three to four times a day, placing hot towels over her eyes every night or so and sometimes using a special gel.
She has remained true to her treatment plan, and dry eye disease has not hindered her from being active, doing well in her job, volunteering, and living a full life.
“Dry eyes is something manageable, if you take ownership in managing it… There is hope, there is a management programme you have to follow. And if you follow it, you’ll reduce the problems you face,” she said.
This article appeared in The Straits Times first.
Source: Her World
