Sitting Raises the Risk of Dry Eye Disease

Being sedentary increases the risk of dry eye disease, but physical activity can lessen that risk, according to new research published in the April 2023 issue of The Ocular Surface.

Sedentary behavior has been linked with low-grade systemic inflammation, which could disrupt the ocular surface, investigators said. Dry eye disease is a common condition where tears don’t provide adequate lubrication, causing discomfort and vision problems. It is more common in women and older people.

Investigators, led by Long Nguyen in the department of Plastic and Reconstructive Surgery, Oslo University Hospital, wanted to clarify the link between sedentary behavior and dry eye disease in the general population. They assessed 48,418 people from the population-based Lifelines, a large, multigenerational cohort study that includes more than 167,000 people from northern part of the Netherlands. Lifelines includes assessments of biomedical, sociodemographic, behavioral, physical, and psychological factors, as well as morbidity and genetics. Participants were enrolled in Lifelines between 2006 and 2013 and will be followed for 30 years.

Lifelines assessed dry eye disease within a general questionnaire given between 2014 and 2017. Physical activity was assessed as part of this effort with a separate questionnaire. It collected information on commuting, leisure time and sports, household work, and employment and school and also collected data on frequency, duration, and intensity of each activity. Participants reported their sedentary behavior using the Marshall Sitting Questionnaire, which assesses sitting time on across five areas: transportation, work, television watching, at-home computer use, and leisure. This questionnaire was administered between 2015 and 2019.

Investigators found that greater sedentary behavior was tied to a higher risk of having dry eye disease in this Dutch population. They suggested computer use, an established risk factor for dry eye, likely explains part of the link between sedentary behavior and dry ey in this study. Prolonged computer use reduces blink frequency, increases incomplete blinking and accelerates tear evaporation.

The research findings also showed that the association of being sedentary and dry eye remained even after adjusting for almost 50 other conditions. With several diseases there was an increased risk of dry eye disease, including type 2 diabetes, depression and connective tissue disease.

Investigators found, however that physical activity helps to lessen the risk of dry eye disease. “Our study is the first to report a modifying effect of PA [physical activity] for this association and could indicate PA as a potential preventive measure against DED [dry eye disease], although causation cannot be assumed from this cross-sectional study,” they wrote.

One limitation of the study is that participants self-reported retroactively. Another is that sedentary behavior and dry eye disease were reported at different times.