Researchers at Aston University have called for more advice to be given to young people about preventing dry eye disease (DED), after a study1 carried out in conjunction with Oslo University Hospital and Sørlandet Hospital Trust in Norway found that 90% of participants had at least one sign of the condition in their eyes.
Risk factors for DED include stress and wearing contact lenses. In the 18-25 age group, a major risk factor is screen use. The condition is more prevalent in women.
It is concerning to note the increasing prevalence of dry eye disease signs and symptoms in young adults
The research, following 50 18-25-year-olds over time, was led by Dr Rachel Casemore at Aston University School of Optometry and is the first of its kind. The researchers looked for symptoms of DED in the participants, studied lifestyle factors, and followed up with participants one year on to find out if there had been any progression of the condition.
Results Indicate Need for Advice
They reported that 56% of participants fulfilled the TFOS DEWS II criteria for DED. 48% had at least 25% meibomian gland loss in either lid, regardless of dry eye status, while over 90% had at least one diagnostic sign.
Progression was characterised by significant increases (p < 0.05) in ocular redness, lid wiper epitheliopathy and blink rate. Albumin was upregulated (p = 0.003) in DED, while zinc-α2-glycoprotein, which showed significant correlations with several meibomian gland parameters, was downregulated. Upregulation of both pro- and anti-inflammatory cytokines was observed, with several significant clinical correlations, including IL-1β with meibomian gland parameters.
Additionally, the researchers found correlation between how long the study group used screens and signs of dryness on the eye surface. The average screen use of participants was eight hours per day.
The researchers concluded that the evidence of DED symptoms and progression in the young adults in their study shows the need for early detection of potential signs, and the identification of those who may go on to develop the disease. These individuals can then be advised on managing the condition before progression.
Simple Messaging
Dr Casemore said the simplest ways to slow the progression and development of DED are to take regular screen breaks, to carry out blink exercises to ensure the release of oils from the meibomian glands and to keep hydrated. A healthy, balanced diet, including sources of omega-3 fatty acids, such as oily fish, is also important, as is regular sleep patterns.
Dr Casemore suggested that those with irregular sleep patterns, such as those caused by sleep disorders or anxiety, should seek advice. People who wear contact lenses need to ensure they get regular check-ups to ensure optimum fitting, and adhere to their replacement schedule, wearing time schedule, cleaning regimes and safety advice, such as no sleeping, showering or swimming in contact lenses.
“It is concerning to note the increasing prevalence of dry eye disease signs and symptoms in young adults, which has been referred to as a ‘lifestyle epidemic’ by some researchers,” said Dr Casemore.
“Eye care practitioners are well placed to identify the clinical indicators of dry eye disease and counsel young adults around modifiable risk factors, such as screen use habits, sleeping habits, contact lens use, diet, blinking patterns, and management of stress levels.
“Our future research aims to continue investigation of the potential tear and meibomian gland oil biomarkers, which were identified during the study and further explore the effect of diet on dry eye disease development.”
Reference
Casemore RK, Wolffsohn JS, Dutta, D. A prospective, longitudinal study to assess progression of ocular surface signs, tear cytokines and protein profiles in young adults. The Ocular Surface, Volume 37, 2025, P 57-67. doi: 10.1016/j.jtos.2025.02.011.
