We’ve just started to access a treasure trove of new insights into dry eye’s modifiable risk factors now that the Tear Film and Ocular Surface Society has shared the key findings from its forthcoming report, “A Lifestyle Epidemic: Ocular Surface Disease.” A walk-through of the conclusions by the TFOS Lifestyle Workshop, released in early May, begins to show the overwhelming scope of the problem.
It’s no wonder dry eye is so pervasive: so are its catalysts. Influences as diverse as make-up wear, medication use, digital screens, dietary choices, environmental exposure and the rise of COVID are just a few that get called out by TFOS for attention and, when possible, remediation.
You can find our summary of the initial TFOS release of highlights on our website. We’ll delve even more deeply into this prodigious work after publication of all eight subcommittee reports in The Ocular Surface journal.
Like the society’s last tentpole release, the 2017 TFOS DEWS II report, this new one is anticipated to have far-reaching implications on the practice of eye care aimed at the betterment of ocular surface health.
If you’ll allow me to boil down hundreds of pages of sophisticated analysis and a three-year collaborative effort by many of the top minds in eye care into a single phrase, the lesson of the report is: “It don’t come easy.” (That’s right, a Ringo Starr song from 1971. Just go with it, I’m old.)
There’s a tendency for the public to sometimes view the fulfillment of their medical needs through the same lens as consumer goods and services, where innovations are continuously simplifying and enriching our lives. In an era when we have instant access to so many solutions to our needs and desires, it can be hard to make the mental adjustment to a mindset of taking personal responsibility for our health and wellbeing. In too many ways, we’ve become allergic to effort.
Against those headwinds, optometrists are going to struggle to communicate the TFOS Lifestyle Report’s implications to their patients—because it puts the onus on their shoulders. Some of the biggest dry eye catalysts in a patient’s day-to-day life are unavoidable, like digital device use and the environmental surroundings in which they live and work. It would be unrealistic to expect most people to decrease screen use, for instance, or suddenly move to a less harsh climate.
So, as you process the latest TFOS recommendations, look first for the low-hanging fruit. Recommend simple modifications to sleep and dietary habits instead of wholesale changes, teach a make-up regimen that allows personal expression but isn’t oblivious to the vulnerability of the eyes, have conversations about optimizing screen viewing instead of giving a lecture about reducing device use outright, encourage efforts to create better (or, hey, any) diligence toward proper contact lens hygiene, and so on. If people start seeing results, they’ll be motivated to try some of the harder lifestyle changes that can make a substantive difference.
Sustainable ocular surface health may not come easy, but patients can get there if they’re willing to listen—to you and to Ringo.