Dry eye disease on the rise amid pandemic

More new patients have been referred to the Singapore National Eye Centre (SNEC) for dry eye disease amid the Covid-19 pandemic.

Covid-19-related factors such as more time spent staring at screens due to work-from-home arrangements, mask-wearing, stress and lack of sleep have contributed to the rise, said Professor Louis Tong, senior consultant at SNEC's corneal and external eye disease department. He said SNEC saw 323 new referrals last year - about a 15 per cent increase from 281 in 2019, prior to the pandemic.

He added that while dry eye disease is an umbrella term for a variety of conditions, the majority of sufferers usually have one or more of these symptoms: irritation of the eyes, intermittent blurred vision, tired eyes, watery or teary eyes, or experiencing glare or discomfort around lights.

About 90 per cent of those with the 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 per cent have a medically significant form of the disease, which comes not only with the symptoms but also ocular damage.

Patients typically get medically significant dry eye disease due to factors such as having undergone bone marrow transplant or autoimmune disease, said Prof Tong.

A multitude of other factors can lead to the community form of dry eye disease, he added, including hormonal issues, ageing, a lack of exercise and menopause.

Three factors have become more prevalent as a result of the pandemic, which contributed most to the rise in new referrals as well.

One is linked to an increase in the time people spend staring at screens due to work-from-home arrangements. This is because people staring at something intensively blink less, allowing oil to build up in their eye glands and exposing their eyes to the air for a longer time.

The increased use of face masks is also a factor. "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.

Prof Tong added that dry eye disease can impact people's jobs, mental health and their ability to do things like drive at night.

Having lived with dry eye disease since 1992, Ms Juliana Ang is no stranger to the multitude of symptoms. The deputy director of human resources said that among other things, she suffers from pain in her eyes, intermittent blurry vision and discharge from the corners of her eyes at times.

Prof Tong said that for a majority of patients, the condition can be managed without seeing a doctor - by steps such as getting more sleep and exercise, regulating screen time, using an eye-warming mask regularly and applying eye drops before staring at a screen.

But if the condition does not improve despite trying all of these steps, the patient should seek medical attention or consult an optometrist.

Ms Ang manages her condition by applying eye drops three to four times a day, placing hot towels over her eyes almost every night, and sometimes using a special gel as well. Because she has stuck to her treatment programme, dry eye disease has not stopped her from living an active life. "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.