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This is a LONG post but very much worth the read...
I was recently diagnosed with dry eye disease (DED) at 39, which is very young (but more and more young people, even teens and 20s, are getting diagnosed with this due to our excessive use of screens). Something else peculiar is that it affects females more than males (yay, and just another reason to keep holding men accountable and not accept low level bs - we always get the short end of the stick in medical issues we face and in healthcare treatments)!
I imagine my job was the culprit since I work 8-10 hours on a comp. every day with minute and microscopic details involved (tons of spreadsheets, tiny numbers, etc.). BUT, it turns out one of the most major causes of DED is looking at screens because when we are staring at screens, we blink way less than we normally would. While blue light blockers and low brightness settings help, it is the lack of blinking that tends to be the #1 culprit for causing this, which is directly caused by too much screen time.
Unfortunately, DED takes a long time to accumulate and become a problem. Chances are you won't know it's happening to you until it has put you in a really bad state and you actually start to feel it. It goes unnoticed for a very long time and the symptoms are very strange.
Once you have it, it's progressive, you will always have it, and there is currently no cure. Once the process starts, your meibomian glands become blocked and you stop secreting oil or quality oil to lubricate and protect your eye. They call this Meibomian Gland Dysfunction (MGD).
You'll experience:
1. Absolute exhaustion all the time and no amount of sleep will help you. You'll constantly feel the need to sleep (your body confuses needing to rest/close the eyes with needing to sleep), but you will wake up feeling like you've never slept a day in your life, no matter the amount of sleep you got.
2. Blurry vision and an awful time driving (especially at night). Healthy and quality oils help our eyes focus. The scariest part pre diagnosis was watching my vision get worse, but my eye doc telling me my vision was technically improving. It was really confusing and scary!
3. Bad headaches.
4. Nausea
5. Your eyes will hurt with the pain of a thousand suns.
6. Wind and exposure outside will ruin your whole day.
Nothing that can help MGD or DED is covered by insurance. Literally nothing. All treatments and drops are expensive (think eye drop bottles for 600 and 800 dollars and in office treatments at 2,000 dollars). One "fun" treatment that I've heard works well is making eye drops from your blood. It's also expensive. You will always be cleaning your eyes with expensive wipes, daily, and using a heated eye mask, every day, to heat up the oils in your eye followed by eye massages to get them moving. You'll be stuck to humidifiers as well.
If you have rosacea, you are more prone to developing ocular rosacea (which will cause DED).
There are lots of things you can do to prevent this, and I would honestly start now if you are on screens a lot (phones included):
1. Blinkingmatters.com I just put this app on my work computer a week ago that reminds you to blink, follow the 20-20-20 rule, look out windows and focus on things outside, and reminds you to take full screen breaks. It's been helpful. Start it now rather than starting it after the fact... it barely helps me now with the current state I made it to, but this app is amazing for being preventative about it.
2. It sounds silly but blink A LOT. Squeeze your eyelids hard together. Sometimes just not having fully closed blinks (even if you blink a lot) will cause DED.
3. Tretinoin and Retinol will absolutely cause this and it doesn't matter where you put it on your face (meaning it doesn't have to be close to the eye) because anything you put on your face eventually migrates into your eyes. Many, many cases of DED were solely caused by Tret and Retinol.
4. Don't use lash growth serums. They have also been proven to cause this. In fact, they cause it really quickly...like within a month or two.
5. Avoid eye drops like Lumify and Visine. ONLY use preservative free eye drops if you use any (might as well start now if you've been on screens a lot for at least a year or two). Eye drops that are not preservative free will not only cause DED, but it will cause damage to your cornea, retina, cones, etc. They are insanely bad for you.
5. This might be diving deeper than you'd like to, but if I could go back in time with this info, I would have avoided all cosmetics and skincare that contain phenoxyethonal (another preservative). It has been proven to be very damaging to eye glands and can certainly cause DED. I've done a pretty good job of fully eradicating it out of my life, but it can be tough. My shampoo and conditioner still contain it. Try to take it in little chunks at a time. Next time you buy a new lotion, look for one that doesn't contain phenoxyethonal, and just continue that process with the things you buy. It is REALLY bad for us.
BAK - benzalchonium chloride is also another big one to try to avoid.
A long list of phenoxyethonal-free products can be found here - https://www.skinsafeproducts.com/search/products?brand_ids=&retailer_ids=&drug_type=&category_id=1&sort_by=&page=23&products_by_ingredient=159&includes_ingredient=false
If you tight line your waterline with eyeliner, I would stop. It clogs your glands.
6. Wash your face and properly remove all makeup, every single night. If you use micellar water, go for the yellow one by Garnier or Bidoerma. The typical pink one by Garnier contains phenoxyethonal.
7.Be careful with taking
antihistamines. They can also cause it.
If you want to read more about it all, the blinkingmatters app has a nice little FAQ sheet that really helped me get a grip on what was happening with me - https://www.blinkingmatters.com/dry-eye-syndrome
It took 2 months of reading, post diagnosis, to understand the whole concept of DED fully.
I know for sure I have been dealing with this for at least 3 years. I had no idea what was happening to me and had regular eye check ups. If you suspect anything, request a meiobography from your doctor. A lot of times they skip this simple test if the patient isn't complaining or noticing any symptoms. This is why it's really possible that you won't know what's wrong until you hit a very bad state and you're in a ton of pain and unable to function through normal days.
A bit of a side rant... I'm shocked that nobody ever talks about this. It is a very serious and very expensive disease and all of us use screens way too much! I would rather be preventative than get to the state I was in. Today I spent 500 dollars for one of four IPL and Radiofrequency sessions I will need (and in the end it is not guaranteed to work, but it is one of my best bets). It will be 2 grand in total. Prior to that, I had been suffering for YEARS. I couldn't take anything less than a 3 hour nap any time I rested. I was always so, so, so tired. I was constantly nauseated (like just got off a rollercoaster nauseated). What's funny is my eyes looked no different during these years, and I never had eye pain that I could connect it back to. I knew something was wrong with me, but I couldn't place what it was... So if you're thinking, "My eyes feel fine," don't rely on that. It's a very, very sneaky disease. The ultra confusing thing was my eye doc telling me my very slight vision issues (I don't even wear glasses and never have) were improving year by year when I felt like I was actually slowly going blind... I'm telling you, I really couldn't see by the time we got this figured out. It was scary.
My first session today for IPL/RF is really helping, already, so I'm hopeful I will be able to get to a better state. It will never go away fully, but you can find and do at home things that improve your levels of MGD. I'm taking a ton of supplements (Omega 3s, Vitamin B12, Magnesium, Zinc, and Vitamin D), eating a ton of salmon, running a humidifier full time at home (I WFH), using a heated eye mask, eye cleansing wipes, doing eye massages, paying attention to the app on my computer and turning brightness levels to barely visible and putting them in night mode (warm, soft lights are your friend), and using manuka honey gel in my eyes twice a day. I've felt improvements and I know things are on the upswing, but I wish I would have known ahead of time. I wouldn't wish this on anyone and it is PRICEY and time consuming to treat!
You NEED eye breaks, full and frequent blinks, low lights on your screens, and to be careful with the cosmetics and eye drops you use. I know most people at my job are headed in a similar direction so I'm trying to hint to them as well...
I hope this helps you all to check in with yourselves! If you're suspecting anything or know that you have used screens heavily for at least a year (or any of the lash serums, etc. mentioned above), request a meibography at your next eye appt!
Do you think it mainly affects women more because of tretinoin and makeup use?