In 2017, we launched or Adolescent Dry Eye Clinic due to an overwhelming increase in symptoms of dry eye among pre-teens and teens secondary to excessive screen time and/or inappropriate use of cosmetics. The purpose of this service is to raise awareness and promote preventative care with age-appropriate material. We are among the first clinics to focus aggressively on early intervention and prevention of dry eye in young people.
The condition of dry eye was previously thought to be a condition occurring in older people; however, over the past decade, The Korb Dry Eye Center has found increasing numbers of children exhibiting the signs of dry eye, findings which are now also supported in other studies. Most often, the children are not reporting a feeling of dryness because they cannot articulate the problem, but upon examination signs of dry eye are seen.
Blinking is the primary mechanism for wetting the eyes. The blink rate slows down significantly with screen time, which induces staring. The action of the blink spreads tears over the eyes. The blink rate must be frequent and the blink action must be complete, with the upper lid meeting the lower lid to make closure, providing wetting of the entire eye to replenish the tears. A secondary action of the complete blink results in the release of oil from glands along the lower lid margin. This oil provides the tear film with its thicker outer layer.
Over time, poor blink habits can result in a feeling of dryness, redness of the white part of the eye, and, with an examination, signs of dryness, including blockage of the glands along the lower lid margin. This blockage decreases the amount of oil, causing the tears to evaporate more quickly, leading to symptoms.
Parents should observe their children while on screens and determine if they are staring and, therefore, blinking infrequently. It is also important to ensure that breaks are taken. Follow the 20/20/20 rule: every 20 minutes, take a 20-second break to look 20 feet in the distance and to blink multiple times. You will have to remind your child to do this. Using alarms is a great way to remind them when you are working.
It is important for children to have eye examinations to detect problems in the early stage when changes can be made and treatment began. It is important for you to understand that once the glands are blocked, they begin to atrophy, which is a permanent problem. Your children need to spend a lifetime on screens, and early education is an important part of self-care. Untreated dry eyes can lead to lifelong problems with discomfort and difficulty with successful contact lens wear. It is easier to prevent a problem than to treat one.