Optimisation of blinking exercises for dry eye disease
Abstract
Purpose: Blinking exercises can reduce the signs and symptoms of dry eye disease, but the optimum technique, repetitions and repeats/day are unclear. Hence, this study used an instructional app to assess the best routine for blinking exercises.
Method: In the optimisation stage, dryness symptoms with the Ocular Surface Disease Index (OSDI-6-item), Symptom Assessment Questionnaire iN Dry Eye (SANDE), and the time the eyes were comfortable for after a blink (the Blink Test) were assessed in 98 participants with dry eye before and after 2 weeks of blinking exercises, as well as 2 weeks after completing the blinking exercise routine. Participants were randomised between a squeeze and blink compared to blink only regimen, 2 to 4 repeats per day and 5 to 25 repetitions each time. A second efficacy study with 28 participants with dry eye disease assessed the optimum app parameters based on symptom severity and frequency, blink rate/completeness, tear film stability and volume, along with ocular surface staining over the same time period.
Results: Overall, blinking exercises reduced symptomatology (p 0.05). However, there was no significant effect on the blink rate, non-invasive tear breakup time, tear meniscus height or corneal staining (p > 0.05).
Conclusion: Fifteen repeats of close-squeeze-open cycles, 3x/day was the optimum blinking exercise routine, reducing symptoms, number of incomplete blinks and conjunctival staining.
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 98 participants or records.
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