# Impact of screen use on tear breakup time: associations with ophthalmological factors and break frequency in office workers

## TL;DR

Office workers who use screens for long periods experience reduced tear breakup time, but frequent short breaks and corrected vision can help prevent this.

## Contribution

Identifies screen exposure and break frequency as key factors affecting tear film stability in office workers.

## Key findings

- Tear breakup time significantly decreased after prolonged screen use.
- Frequent short breaks (<15 min) protected against tear breakup time reduction.
- Uncorrected refractive errors increased the risk of significant tear breakup time decline.

## Abstract

To examine how ophthalmological features, screen exposure duration, and break
habits among office employees affect ocular surface parameters.

This single-center cross-sectional study involved two assessments on the same
day: one before and one after a visual display terminal task. During the
initial assessment, information on screen use was gathered, and refractive
error, anterior segment examination, tear breakup time, and Schirmer test
measurements were conducted. Participants tracked their screen usage and
break durations throughout the day. At the end of the workday, tear breakup
time and Schirmer I tests were repeated. Baseline and follow-up results were
compared, and regression analysis was performed to identify factors linked
to tear breakup time reduction.

The study enrolled 60 female office employees. Their mean screen time was
269.26 ± 70.21 min, with an average break duration of 151.93 ±
46.24 min. Tear breakup time at the second assessment (6.38 ± 2.70)
was significantly lower than at baseline (8.62 ± 2.73) (p<0.001),
whereas Schirmer test scores showed no significant change (p>0.05). Tear
breakup time reduction was noted in 54 participants (90.0%), with a
significant association between tear breakup time decrease percentage and
screen exposure (p=0.001, r=0.463). Regression analysis showed that
uncorrected or undercorrected refractive error was an independent risk
factor for a ≥30% tear breakup time reduction, while taking more
frequent short breaks (<15 min) acted as a protective factor.

Taking more frequent short breaks (<15 min) and correcting refractive
errors help prevent intra-day tear breakup time decline during visual
display terminal use. Structuring breaks to support tear film stability is
advisable for occupations that require regular visual display terminal
tasks.