Digital display use and contact lens wear: Effects on dry eye signs and symptoms

Purpose To assess the potential additive effects of short-term display use and contact lens (CL) wear on the ocular surface and tear film. Methods Thirty-four healthy volunteers (20.87 +/- 2.33 years old) participated in this study. Participants' dry eye symptoms, ocular surface, tear film and pupil size were assessed before and after executing a 20-min reading task on a computer and a smartphone with and without CL wear, or with CL wear and artificial tear instillation. Measurements included the Ocular Surface Disease Index (OSDI) questionnaire; 5-item Dry Eye Questionnaire (DEQ-5); tear meniscus height (TMH); noninvasive keratograph break-up time (NIKBUT); bulbar conjunctival redness (BR) and pupil size. Results Higher symptoms were reported after reading on both displays with and without CLs (p <= 0.001) for short periods. BR was higher and NIKBUT shorter after reading on the computer regardless of wearing CLs (p <= 0.02 and p <= 0.02, respectively), while TMH increased for all conditions (p <= 0.02) except for CL computer reading (p = 0.23). Reading with CLs did not lead to greater signs of dry eye (BR, NIKBUT) and symptoms compared with reading unaided (p > 0.05), although a smaller increase in TMH was observed when reading on the computer with CLs (p = 0.005). Artificial tear instillation during CL wear led to a smaller increase in symptoms (p <= 0.02), a smaller increase in BR (p <= 0.04) and a decrease in NIKBUT (p = 0.02) compared to reading without correction. Conclusions Disposable CL wear had no additive effects on signs and symptoms of dry eye when using digital devices for short periods. The instillation of artificial tears is an effective strategy for reducing the impact of display use in CL wearers.