Blinking – Key for Dry Eyes, Tired Eyes

Did you know that blinking helps prevent dry eyes?

The most frequent complaint to eye doctors is dry eyes, known as aqueous insufficiency, meibomian gland dysfunction, or dry eye syndrome. Twenty-five percent of patients who visit ophthalmic clinics report symptoms of dry eye, making it a growing public health problem and one of the most common conditions seen by eye care practitioners.1

As we age we are more likely to experience dry eye: 2.7% in people aged 18-34, but 18.6% over 75 years old.  Women are twice as likely to suffer from dry eye as men. 2

Symptoms typically include irritation, dryness, burning, grittiness, difficulty reading for long periods of time, and, even though it may seem contradictory, excessive watering or tearing as the eyes attempt to solve the problem.

Anatomy of our tears

The moisture-laden surface of the eye contains three interrelated layers known as the tear film. Stable continuity of that surface and the production of tears rely on the function of these three layers, which need to be produced in proper balanced amounts by the body to avoid dry eye syndrome:

  • Mucous layer. The innermost layer of the surface of the eye is a mucous layer that forms the bulk of the tears and contains electrolytes, a variety of proteins, and water. It also has some anti-microbial properties.
  • Aqueous layer. On top, on the outside of the mucous layer, is a mildly alkaline aqueous layer (watery) comprising up to 90% of the thickness of the tear film.
  • Meibum layer. Outside the watery layer is an oily lipid layer that slows the evaporation of the tear film. This thin layer is made up of meibum, produced by the meibomian gland.

Essential blink function to fight dry eye

The blink function is key to keeping the surface of our eyes moist. We take blinking for granted, but the American Optometrists Association recommends consciously blinking more regularly to help with dry eye.

The normal blinking process acts as a pump on the lacrimal sac, the gland that produces tears) to move more fluid to the eye and distribute it across the surface of the eye. Blinking brings material from the watery and oily layers and helps to remove debris. It is an essential part of eye comfort because the tear film naturally begins to degrade after about 10 seconds and needs renewal. Therefore, we normally blink automatically about 10-12 blinks a minute.

Sometimes we don’t blink enough

Blink rates matter because after about 10 seconds the tear film is unstable and poorly protects the surface of the cornea from irritation.

Studies have shown that computer users blink less while using the computer. When focused intently on something, our blink rate slows, as when working on the computer, which can result in dry eye syndrome.

Under relaxed conditions our mean blink rate is as high as 22 blinks/minutes. During normal daily activity our blink rate is about 10-15 blinks per minute, when working on the computer our blink rate slows.3 Different studies report a wide variation in blink rates.  One study reports a normal blink rate during a conversation at about 17 blinks/minute, but only 6 blinks/minute when reading.4

Partial blinking is a problem

A partial blink, not fully covering the cornea is also significant.5 It is the cornea that tells the brain to send messages to the body to produce more or fewer tears and when to blink. Solving incomplete blink patterns may require establishing new motor memory of voluntary complete, rapid, and relaxed blinking as a basis for efficient spontaneous blinking. “Voluntary forceful blinking may undermine the motor memory of efficient blinking and risk the depletion of any reserves of lipid.”6

Blinking exercises can be really helpful to strengthen and maintain your blink response, especially if you suffer from chronic dry eye syndrome. Do these easy exercises several times an hour, especially while sitting at your desk working on your computer, or while reading.

#1 Close and open eyelids

  • Gently close your eyes.
  • Keep your eyes closed for 2 seconds.
  • Gently open your relaxed eyes
  • Repeat 5 times

#2 Close, squeeze, and open eyelids

  • Gently close your eyes.
  • Keep your eyes closed for 2 seconds.
  • While your eyes are closed, squeeze your eyelids together slowly and gently.
  • Gently open your eyes and relax them.
  • Repeat 5 times

Lifestyle support for dry eye

  • Drink plenty of water. Small sips frequently are more effective and comfortable.
  • Use a humidifier to add moisture to the air in your bedroom
  • Anti-inflammatories. There is some evidence that reducing inflammation is helpful.
  • Supplement with helpful nutrients and eyedrops (see recommendations below).
  • Managing stress is important for managing this condition
  • Pay attention to drugs that harm the eyes

Footnotes

  1. O’Brien, P.D., Collum, L.M. (2004). Dry eye: diagnosis and current treatment strategies. Curr Allergy Asthma Rep. 4:314–319.
  2. Farrand KF, Fridman M, Stillman IÖ, Schaumberg DA. (2017). Prevalence of Diagnosed Dry Eye Disease in the United States Among Adults Aged 18 Years and Older. Am J Ophthalmol. 2017; 182:90.
  3. Abusharha AA. (2017). Changes in blink rate and ocular symptoms during different reading tasks. Clin Optom (Auckl). Nov 20;9:133-138.
  4. Portello JK, Rosenfield M, Chu CA. (2013). Blink rate, incomplete blinks, and computer vision syndrome. Optom Vis Sci. May;90(5):482-7.
  5. Ibid. Portello. (2013).
  6. McMonnies CW. (2021). Diagnosis and remediation of blink inefficiency. Cont Lens Anterior Eye. Jun;44(3):101331.

Make your appointment today

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At Golden Eye Optometry, we view good vision care as front line protection at every age. A routine eye exam can detect more than poor vision. It can shed early light on glaucoma, macular degeneration, cataracts and diabetes.

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