Table 2.
Studies with prolonged follow‐up with objective measures.
| Study | Sample | Design | Preventive measure | Follow‐up | TBUT | OSS | Blink rate | Symptom score | Other study outcomes |
|---|---|---|---|---|---|---|---|---|---|
| Bhargava et al. 2016 (IN) | 522 symptomatic VDT users | Double‐blinded RCT | Omega‐3 fatty acid | 45 days | ↑ | ↑1 | Oral omega‐3 fatty acids improved CIC, but not Schirmer score after 45 day. The group receiving omega‐3 fatty acids improved symptom scores, whilst the control group did not improve symptom scores. The improvement in symptom score for the intervention group was significant compared to the control group | ||
| Bhargava et al. 2015 (IN) | 456 with CVS symptoms | Double‐blinded RCT | Omega‐3 fatty acid | 3 months | ↑ | ↑1 | Oral omega‐3 for 3 months improved Schirmer and Nelson Grade significantly. 70% of patients receiving treatment were symptom‐free post‐intervention versus 15% in the control group | ||
| Ribelles et al. 2015 (ES) | 148 post‐menopausal women (46% with DED) | Open‐label RCT | Omega‐3 fatty acid | 45 days | ↑2 | Oral omega‐3 fatty acids reduced biomarkers of inflammation in tear fluid compared to controls. Almost 70% of the participants receiving omega‐3 improved their DED symptoms as compared to the group not receiving supplements | |||
| Park et al. 2016 (KR) | 50 healthy VDT users | Double‐blinded RCT | Oral intake of Vaccinium uliginosum | 4 weeks | — | ↑ | No change in high‐order wavefront aberration after oral intake of Vaccinium Uliginosum. Those receiving Vaccinium uliginosum had greater improvement in symptoms after VDT use than controls | ||
| Utsunomiya et al. 2017 (JP) | 63 DED patients | Prospective controlled | Diquafosol 6 times daily | 3 months | ↑ | ↑ | ↑3 | OSS and TBUT improved significantly more with diquafosol than in the control group. Tear volume and Schirmer score were not significantly increased at 3 months. Symptom score improved significantly in the intervention group but not compared to the control group. The effect was strongest during VDT use and reading | |
| Shimazaki et al. 2017 (JP) | 67 office workers | Open‐label RCT | Rebamipide and diquafosol | 8 weeks | ↑ | ↑* | ↑3 | Both mucin secretagogues improved symptoms at 8 weeks. There was no difference in symptom scores between the two groups. Both secretagogues improved TBUT after 2 and 4 weeks. Only rebamipide improved TBUT after 8 weeks | |
| Calvao‐Santos et al. 2011 (PT) | 27 symptomatic computer users | Open‐label RCT |
3 different AT Tears again®, Opticol® and Optive® |
30 days | — | ↑2 | Artificial tears decreased patients' OSDI score from baseline, but not compared to a control group receiving no treatment. The groups receiving Tears Again® and Opticol® had improved Schirmer's score compared with baseline, but not significantly when compared to control group | ||
| Hirayama et al. 2013 (JP) | 20 VDT workers with DED | Open‐label RCT | MCAD during VDT use | 5 days | ↑ | — | — | ↑4 | MCAD increased tear volume and functional VA improved. Standard VA did not improve. Blink rate increased during VDT use in the control group, but not with MCAD. Tear evaporation rate was steady with MCAD use |
| Nosch et al. 2015 (CH) | 24 computer users | Prospective controlled crossover | Blink animation programme during VDT use | 1 weeks | ↑ | ↑2 | Blink rate increased when using blink animation software compared to the placebo group. Symptom scores improved for both test and placebo groups | ||
| Sun et al. 2020 (TW) | 44 VDT user with DED symptoms | Single‐blinded RCT | 10 min EWS for 2 weeks | 2 weeks | ↑ | ↑ | ↑3 | TBUT increased from baseline in the study group, but not compared to the control group. There was no significant change in meibomian gland drop‐out score or meibum impressibility score after 2 weeks treatment | |
| Chlasta‐Twardzik et al. 2021 (PL) | 128 office and medical workers | Observational study | Various work environment factors | 1 year | ↑ | ↑2 | Low air humidity and rooms with AC increased dry eye symptoms. An increase of lighting intensity reduced the chance of an abnormal TBUT measurement | ||
| Ashwini et al. 2021 (IN) | 46 computer users with DED | Single‐blinded RCT | Blink animation programme during VDT use | 30 days | — | ↑ | ↑2 | Blink animation significantly improved OSDI score compared to baseline and control group after 15 and 30 days. There was no difference in blink rate after 15 days, but it improved significantly after 30 days compared to baseline |
1dry eye scoring system (DESS), 2ocular surface disease index (OSDI), 3dry eye related quality of life score (DEQS), 4visual analogue scale (VAS).
AC = air‐condition, AT = artificial tears, CIC = conjunctival impression cytology, CVS = computer vision syndrome, DED = dry eye disease, EWS = eyelid warming steamer, LLT = lipid‐layer thickness, MCAD = moist, cool air device, OSS = ocular surface staining, RCT = randomized controlled trial, TBUT = tear film break‐up time, TMH = tear meniscus height, VA = visual acuity, VDT = visual display terminal.
↑ significant improvement at p < 0.05, — no significant difference.
*
Increased in rebamipide group only.