HSE measures for better eye health
Digitalization and increased screen use
Dry eyes, screen use and HSE measures
Dry eyes are one of the most common and widespread eye conditions we have in Norway, and the condition affects up to 50 percent of the population to a greater or lesser extent. Here we look at how it is possible to ensure the best possible eye health and prevent dry eyes, Computer Vision Syndrome, etc.
The tear film is not working properly.
The disorder revolves around the tear film, a thin membrane that moistens and nourishes the surface of the eye and which must be intact for us to see clearly. Dry eyes are caused by a disruption in the production of tear fluid and/or lipids and cause the thin tear film to not function properly.
Aging, hormonal imbalance with reduced androgen levels (male sex hormones), cataract and lens replacement surgery, diseases such as diabetes and rheumatism and medications for high blood pressure and allergies, can negatively affect the tear and sebaceous glands in the eyelids and thus the function of the tear film.
An inflammatory condition
Dry eyes are usually an inflammatory condition caused by tears becoming too salty (hyperosmolar) due to a lack of tear fluid or lipids. When tears become too salty, inflammation of the cornea and conjunctiva can occur, which can cause irritation such as a sandy feeling, burning, and for some, disabling pain.
Symptoms
Symptoms of dry eyes can include dryness, a sandy feeling, itching, soreness, irritation, burning sensation and pain in the eyes, tired eyes, photosensitivity and increased blinking frequency. Normally, you blink 8–12 times per minute to moisten the eye. With dry eyes, you compensate by blinking more often, i.e. more than 12 times per minute. Other symptoms include: tearing, varying visual acuity and red eyes, as well as discomfort when using screens and wearing contact lenses. The condition can lead to reduced quality of life due to impaired vision, ocular discomfort and, ultimately, disabling pain.
Triggered and worsened by lifestyle
Dry eyes are a condition that can also be triggered and worsened by our modern lifestyle and technological society. Increased evaporation of the tear film as a result of screen use is a common problem and the condition is referred to as Computer Vision Syndrome (CVS). The reason for the increased evaporation is that the blink rate is reduced and, in the worst case, halved when looking at screens. It is also unfortunate that you blink less often and incompletely, since blinking is the very engine for the excretion of fats. from the meibomian glands in the eyelids to the tears.
HSE measures for maintaining good eye health
It is possible to ensure the best possible eye health and, among other things, prevent dry eyes, computer vision syndrome, etc. by:
- Adjust the screen, table and chair. 50–70 cm distance, angle the screen 15–20 degrees backwards, and let the center of the screen be at a viewing angle of 15–30 degrees below the horizontal line.
- Reduce brightness and avoid poor lighting. Avoid fluorescent lights above the screen, use a desk lamp that provides good light over the keyboard.
- Avoid glare and consider color temperature. Position the screen correctly in relation to windows and minimize reflections.
- Filter/block blue light if necessary. Use filter glasses or night/warm color tone on PC/mobile/tablet.
- Use artificial tears.
- Take short breaks. 20–20–20: Every 20 minutes, look at something about 21 feet away for 20 seconds.
- Blink more and more completely. Feel free to use blink reminders/alarms.
- Optimize screen settings. Contrast, sharpness and text size so that your eyes don't have to "overwork".
Check the humidity
Dry eyes can also occur in/be caused by indoor climates with low humidity and high air flow as a result of heating and the use of ventilation systems.
Rune Ødegård (58) – my story
I worked in auditing from August 1988 (licensed as a state-authorized auditor from February 1991) until I was on 100% sick leave in November 2016 due to eye problems. The complaints were irritation, dryness, soreness, a sandy feeling, a high degree of light sensitivity and major problems with concentration when focusing closely at close range, etc.
The tears were missing
At the end of 2016 and the beginning of 2017, the pain was so bad that I almost didn't dare drive, and at the funeral of a very dear relative, not a single tear came, which I found very abnormal for me to be.
On sunny days I had to stay indoors with special filter glasses.
Common to my employers, in all the years I worked in auditing, was a total absence of HSE measures aimed at screen use, lighting conditions, etc. However, two paid for the computer glasses of the time. In January 2017, I was 70% sick, but had to work far more than 30% would indicate, i.e. I had to strain my already damaged eyes to help my employer complete a large assignment within a deadline. The consequence was further worsening of my eye problems and I was again on 100% sick leave. Since then I have been on sick leave and have undergone work clarification.
Started with a lot of overtime
The problems began in the spring of 2013 after I, especially in 2012 and the first part of 2013, had worked very hard during the entire annual settlement period, for example 100 hours of overtime in just one month.
I visited my optician for an examination and was given artificial tears to use during the day and eye ointment to use at night.
Surgery and constant examinations
A doctor believed that heavy eyelids could be part of the cause of the discomfort, as they rubbed against the eyes.
The eyelids were operated on without any help and the symptoms gradually got worse, although they improved somewhat during vacations – that is, when the eyes were free from the screen.
Indoor climate (practical)
In general, an indoor relative humidity of 20–40% (the higher the better) at a room temperature of 20–22°C is recommended. Humidity can be increased by, for example, reducing the fan speed in the ventilation system and using a humidifier for limited periods of time. If possible, the humidifier can be installed with a thermostat so that it turns on automatically when the humidity falls below the desired level.
Medical aids
There is a wide range of eye drops and other aids to combat dry eyes. Artificial tears are used to lubricate the surface of the eye, dilute the tear film, reduce the concentration of inflammatory substances in the tear film, and replace substances that are missing from the tear film.
On a blue prescription
If you have chronic dry eyes and the examination shows that you have reduced tear quality or quantity, you are entitled to prescription medication.
Corticosteroids and cyclosporine are eye drops that inhibit the inflammation and ulceration of the eye's surface that are associated with dry eyes.
Corticosteroids are usually used in the acute phase or when the condition worsens and should only be used for limited periods of time due to the risk of pressure increase and cataract development.
Cyclosporine is indicated for moderate to severe dry eyes and is used over long periods of time.
Visit a pharmacist, optician or ophthalmologist
If you suffer from dry eyes and have problems related to screen use, you should see a pharmacist, optician or ophthalmologist.
Mild dry eyes can be treated by an optician, but moderate to severe dry eyes should be treated by an ophthalmologist with prescription medications.
I had regular checkups with an optician, a family doctor, a public and private ophthalmologist, and an optometrist. From these I received various eye drops, eye ointments and heat treatment of the eyelids, but no one could provide proper help and no one understood what direction it was heading. However, I received a tip to contact the Dry Eye Clinic in Oslo, and the treatment began there on January 24, 2017.
A chronic and lifelong diagnosis
The results of all the eye examinations allowed Sten Ræder to make the following diagnosis: Computer Vision Syndrome, cicatricial Meibomian Gland Dysfunction (MGD) with up to 75% gland loss in the eyelids, corneal nerve damage, inflammation on the surface of the eyes, severely reduced tear production, abnormally high levels of light sensitivity, etc. The condition is chronic and lifelong.
Better, but disabled
After following the treatment program at the Dry Eye Clinic for over four years, I have gradually improved and dare to drive again, even though I have to stop to drip my eyes and take a break after plus/minus one hour.
I can go outside again when the sun is shining, as long as I wear strong filter glasses. I get tears in my eyes again when there is really something to cry about,
and I can once again read a few pages in a book, go online banking and write short emails before the pain in my eyes comes.
Morality
- Find an employer who prioritizes HSE measures for eye health. Or: demand such measures, and if they are not implemented – change jobs.
- To employers: introduce satisfactory OSH measures for screen use and eye health as soon as possible.
- In case of similar complaints: contact skilled specialists early. Also consider help with specially adapted filter glasses and possible contact lenses.