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| COMMENTARY |
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| Year : 2014 | Volume
: 7
| Issue : 1 | Page : 18-19 |
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Environmental stress and dry eye
Samanthila Waduthantri
Singapore Eye Research Institute, Singapore
| Date of Web Publication | 10-Dec-2013 |
Correspondence Address:
Samanthila Waduthantri
Singapore Eye Research Institute, Singapore
 Source of Support: None, Conflict of Interest: None  | Check |
How to cite this article:
Waduthantri S. Environmental stress and dry eye. Med J DY Patil Univ 2014;7:18-9 |
Dry eye disease (DED) is a chronic condition that affects millions of people world-wide. According to previous epidemiological data, prevalence of dry eye could be as high as 11-30% of the general population and found to be more common in Asians compared with other races. [1]
DED can cause ocular discomfort and visual disturbances that can interfere with daily social and physical functioning, with a significant impact on work place productivity and quality-of-life and associated with a significant socio-economic burden. [2],[3]
Recent studies have shown the importance of environmental factors on pathophysiology of dry eye. [4]
Not only physiological nature of living and working environment such as air-conditioning, low humidity and high velocity wind, but performing activities that require greater visual demands such as using computer, reading, using a microscope and driving, which reduce blinking due to prolonged gazing can increase the tear evaporation. [4],[5]
"Dry eye syndrome: A rising occupational hazard in tropical countries" is a population based survey conducted on 1890 patients in India. In this study, Bhatnagar et al. found a significant association between DED and exposure to excessive wind, sunlight, high temperature and air pollution. Majority of these patients were outdoor workers from rural areas. This study also suggest that habitual activities such as smoking and chewing tobacco may also play a role in inducing or aggravating dry eye. The strengths of the present study include large population-based sample and using validated questionnaires and objective methods to access dry eye.
Due to multifactorial nature of the disease, treatment of dry eye can be quite challenging. Findings of this study emphasize the role of extrinsic causes of DED, especially the harsh environmental conditions. Therefore, treatment need to be more customized according to individual patient's milieu.
Especially for those with evaporative dry eye resulting from life-style factors with frequent exposure to environmental stress such as wind, low humidity or air-conditioning may benefit from moisture retention methods such as specialized goggles, moisture chamber glasses or humidifiers in addition to the conventional treatment with lubricants and anti-inflammatory eye drops.
Further prospective randomized controlled studies are needed to evaluate the association between the severity of dry eye and number of hours, time of the day, type of activities involved and environment. New treatment modalities should focus on targeting these underlying causes of DED instead of conventional symptomatic relief.
| References | |  |
| 1. | Asbell PA, Lemp MA. Dry Eye Disease: The Clinician's Guide to Diagnosis and Treatment. New York: Thieme Medical Publishers; 2007. 
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| 2. | Pflugfelder SC. Prevalence, burden, and pharmacoeconomics of dry eye disease. Am J Manag Care 2008;14:S102-6.
[PUBMED] |
| 3. | Waduthantri S, Yong SS, Tan CH, Shen L, Lee MX, Nagarajan S, et al. Cost of dry eye treatment in an Asian clinic setting. PLoS One 2012;7:e37711.
[PUBMED] |
| 4. | The definition and classification of dry eye disease: Report of the definition and classification subcommittee of the international dry eye workshop (2007). Ocul Surf 2007;5:75-92.
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| 5. | Tong L, Waduthantri S, Wong TY, Saw SM, Wang JJ, Rosman M, et al. Impact of symptomatic dry eye on vision-related daily activities: The Singapore Malay eye study. Eye (Lond) 2010;24:1486-91.
[PUBMED] |
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