How screen time and eyelid health affect dry eye risk

Ashraf Ahmad, MD, a board-certified, fellowship-trained ophthalmologist specializing in cataract and corneal surgery, said the prevalence of dry eye disease is climbing, largely due to increased screen time. The connection traces back to blink physiology: people blink less often while focused on a screen, which destabilizes the tear film.

"That's related to your blink reflex, inherently, whenever we're focused on things, we're just not going to blink as often," Ahmad told the Eye Care Network. He added that catching these patients early allows for earlier intervention and a lower risk of progression to moderate or severe disease.

The definition of dry eye disease continues to evolve

Ahmad noted that the clinical understanding of dry eye disease has shifted substantially. Where it was once viewed primarily as a tear deficiency, the most recent Tear Film & Ocular Surface Society Dry Eye Workshop III (TFOS DEWS III) report classifies it as a multifactorial, symptomatic disease.¹ Ahmad said this reflects a growing recognition of inflammatory, evaporative, and mixed components underlying the condition, which continues to expand the range of available treatment approaches.

The eyelid exam is an overlooked piece of the workup

Asked what factor in dry eye disease is most often underestimated beyond screen time, Ahmad pointed to the eyelid exam. He recommends assessing meibum quality, screening for meibomian gland dysfunction, and evaluating for Demodex, blink completeness, and eyelid anatomy issues such as entropion or eyelid laxity.

"Oftentimes when we examine these patients, we're so focused on the cornea and the conjunctiva," Ahmad said, "but the eyelids are a crucial component as well that we need to address."

Why physician-created content matters for patient education

Ahmad also discussed the value of physician-created educational content, following a recent social media demonstration of the tear breakup time test. He said physicians have a role to play in contributing accurate information directly to patients navigating a crowded information landscape online.

"I think the medical community as a whole should also be contributing, and we should be providing that information as a way for breaking any barriers for patients to receive care," Ahmad said, adding that educational videos can help patients self-identify symptoms and seek specialty care sooner.

Reference
1. Perez VL, Chen W, Craig JP, et al. TFOS DEWS III editorial. Am J Ophthalmol. 2025;278:166-167. doi:10.1016/j.ajo.2025.05.038