Diurnal Variation of Visual Function and Dry Eye

[Scout]

Cornea. 2010 May 6. [Epub ahead of print]

http://www.ncbi.nlm.nih.gov/pubmed/20458235

Diurnal Variation of Visual Function and the Signs and Symptoms of Dry Eye.

Walker PM, Lane KJ, Ousler GW 3rd, Abelson MB.
From the *Ora, Inc, Andover, MA; daggerSchepens Eye Research Institute; and double daggerDepartment of Ophthalmology, Harvard Medical School, Boston, MA.

Abstract

PURPOSE:: Subjects with dry eye often complain of disturbances in visual function and worsening of symptoms in the evening. To clinically substantiate these reports of diurnal variations, the present study tested subjects with dry eye on a series of visual function and ocular physiology measures.

METHODS:: Twenty-one subjects with dry eye were enrolled and underwent ophthalmic examinations, including best spectacle-corrected visual acuity, visual function decay as measured by the interblink interval visual acuity decay test without ocular anesthetic, reading rate test, slit-lamp biomicroscopy, and tear film breakup time. Keratitis, conjunctival redness, and corneal sensitivity were also assessed. Examinations occurred once during the morning and for a second time in the evening. Subjects also completed a modified version of the Ocular Surface Disease Index at both study visits.

RESULTS:: Subjects with dry eye showed impaired visual function in the evening, as compared to that in the morning; they maintained their best spectacle-corrected visual acuity for a shorter time between blinks (P < 0.01) and had longer readings times (P < 0.05) in the evening as compared with that in the morning. These findings were qualified by Ocular Surface Disease Index results showing greater subjective visual impairment in the evening. Subjects also demonstrated a significant increase in keratitis and conjunctival redness from morning to evening testing. Less ocular discomfort was reported in the evening than in the morning; this effect significantly correlated with corneal sensitivity in the evening.

CONCLUSIONS:: Subjects with dry eye experience significant diurnal variations of visual function and ocular surface physiology. These daily rhythms should be considered when designing clinical trials and when quantifying disease severity.

PMID: 20458235 [PubMed - as supplied by publisher]

[Bekkestad]

"Subjects with dry eye showed impaired visual function in the evening,"

[Bekkestad]

"Subjects with dry eye showed impaired visual function in the evening,"

Kidding me? ;-)

[ringo]

anybody can help?

I would say most "subjects with dry eye" show impaired visual function at any time of day or evening, and depending on what they do-- like driving, using a computer, reading, watching TV--my vision gets blurred so often when I drive-- sometimes especially after a long drive it can be scary and dangerous.
The other thing that makes my vision blured and impaired is using a computer, even using my iPhone to browse the internet. I still have no explanation why only 10 minutes on a computer hurt my eyes more than anything else. I blink all the time, but that does not help a bit. My computer screen is lowered, I use dark tinted goggles, have humidifier and switch off any AC when on the computer. I put in drops and gels all the time while at the PC screen, but that also does not help much, as I need to put them more or less every 5 min to get some relief (that is why I have s many typing errors in my posts sometimes-- i just don't see anything!)
I am taking every precautoin possible, and medicaing my eyes, but still the computer is a no go area for me. It costs me a lot of pain and setbacks to the improvement n my eyes. This basically means that I have zero prospect of returning to work any time soon.This makes me more scared and anxious.

Once I am away from the computer, and put all my drops, after like 30 min my eyes start to return to a more normal state.
I also remeber that when my dry eye started first, I had these episodes of horrile stinging and burning in my eyes come over me as I was sitting at work in my cubicle in front of the PC and working. I would get this sudden feeling as if a million wasps are stinging my eye and awful burning, and go to the toilet and try to wash my face and cool my eyes. I would see them extremely red and swollen in the mirror. Then these episodes started to get more and more frequent, and i was using ice cubes on my eyes as I was sitting in my workplace! This is what made me go to a doctor, who misdagnosed me with severe allergy and prescribed for me anti-allergy drops and tablets.
As you can imagine this treatment regimen annihilated what was left of any tears in my eyes. But I persevered thinking that may be things get orse before getting better-- and having absolute trust in the doctor's diagnosis!

That is how my dry eye saga started-- in front of the computer in the office. Computer is my biggest enemy but who can live without it?
I am at a loss as to why computers have this deleterious effects on my eyes, or how to combat the impact.
And when I remember that only a year before the dry eye started, I was a computer games addict! I absolutely loved gaming and browsing the net, even reading books online, chatting,etc.
Now I can't even imagine playing a computer game. God, how my whole life has gotten so much smaller because of the dry eye....

[kitty]

I am at a loss as to why computers have this deleterious effects on my eyes, or how to combat the impact.

When using a computer we don't blink as much. This contributes to DES. To combat the impact, set a timer and take a break. Look someplace else. Blink several times. Maybe go do something else for a while, then work at the computer a bit longer. I know, easier said than done. You need to consciously remember to blink every couple of minutes. Use of a humidifier near your computer might also help.