Ocular surface disease and lifestyle choices that affect eye health

Esen Akpek, MD, sat down with David Hutton, Managing Editor, Ophthalmology Times®, to discuss ocular surface disease and the lifestyle choices that could affect eye health. As well as what The Tear Film & Ocular Surface Society is doing to promote research on the topic.

Video transcript

Editor’s note: This transcript has been edited for clarity.

David Hutton

Hello, I'm David Hutton of Ophthalmology Times. The Tear Film & Ocular Surface Society recently held a lifestyle dry eye workshop. Joining us today to provide her insight on the workshop is Doctor Esen Akpeck from the Wilmer Eye Institute, Johns Hopkins University School of Medicine. Thank you so much for joining us today. Tell us about this workshop.

Esen Akpek, MD

Thank you, David, and thank you for the opportunity to talk about this important workshop. I wanted to start by talking about the Tear Film & Ocular Surface Society - TFOS. Founded in 2000, it is a world leader in eye health education. Headquartered in Boston, Massachusetts, TFOS is a nonprofit organization dedicated to promoting research related to ocular surface disease and disseminate the knowledge gained through meetings and publications. As you may remember, TFOS is the organizer of the Global Dry Eye Workshop whose results were published in 2017, which is one of the main guidance documents in this field.

The current focus of the organization is a lifestyle epidemic ocular surface disease. I also wanted to go over the definition of ocular surface disease. Ocular surface is comprised of corneal and conjunctival epithelium, lids, eyelashes and ednex suhas meibomian glands.

The health of ocular surface is dependent on normal innovation through the fifth nerve, normal lubrication through a healthy 3 layer tear film, which also provides atrophic environment for regeneration of the surface cells. And a normal blinking reflex through the fifth nerve to protect from drying by redistribution, and replenishing of the tears.

Eyes are external organs exposed to the surrounding environment, but they're also attached to the body. Anything in the environment from quality or humidity of air, to health of the bodies such as hydration or nutrition status, or any habitual and lifestyle choices may have an impact on the ocular surface. And the importance of that is that ocular surface diseases can severely reduce the quality of life due to discomfort as well as blurred vision.

For example, being unable to wear contact lenses or sustain prolonged reading for work or leisure are well known to be associated with dry eye. These issues may have an impact on an individual's work or social life. In fact, currently, millions are still working from home dealing with excessive screen time. In extreme cases, ocular surface disease can even cause blindness. For example, a patient with Sjögren’s Syndrome and dry eye might end up with corneal ulcers if not diagnosed timely, and treated aggressively. Which might progress to corneal perforation, and result in vision loss or even loss of the eye.

Another example could be excessive alcohol use, which leads to vitamin A deficiency and subsequent cirrhosis of the ocular surface, which could again lead to corneal ulcers, or even perforation.

The new TFOS lifestyle workshop focuses on how eye problems are increasingly linked to our lifestyle choices, what we do to ourselves, from technology use to beauty routines, to what we eat, to where we live. The goal of this workshop is to advance our understanding and educate people about how our choices may impact our eyes, our vision and our quality of life. Thank you