An automatic movement necessary for the health of the ocular surface and visual comfort is blinking. No studies have measured increases in eyelid opening, despite the fact that blinking exercises have been demonstrated to reduce symptoms, enhance non-invasive tear film breakup time (NIBUT), and reduce incomplete blink rate (IBR) in individuals with dry eye. This study assessed how blinking exercises affected tear film-related metrics, subjective symptoms, and palpebral fissure height (PFH).
After receiving artificial tear drops five times a day for three days, participants were randomized to either the "blinking exercise group," which engaged in blinking exercises, or the control group, which solely utilized artificial tear drops. Scores for dryness, eye strain, ocular pain, blurred vision, foreign body feeling, dullness, and difficulty opening the eyelids were recorded using the Visual Analog Scale (VAS) and the Standard Patient Evaluation of Eye Dryness (SPEED). Lipid layer thickness, blink interval, PFH, IBR, fluorescein staining, tear meniscus height, NIBUT, and fluorescein breakup time (FBUT) were among the parameters taken before and after the research.
Of the 100 individuals, 52 were in the blinking exercise group and 48 were in the control group (28 men and 72 females, mean age 38.4 ± 7.4 years). SPEED (P < 0.001), VAS values for ocular strain and discomfort (P = 0.003, 0.007), expanded PFH (P < 0.001), extended NIBUT and FBUT (P < 0.001), and decreased IBR (P < 0.001) were all significantly improved in the blinking exercise group as compared to the controls.
Overall, these findings imply that, independent of dry eye condition, blinking activities enhance PFH and reduce subjective symptoms. Additionally, blinking exercises helped to stabilize the tear film, regulate blink patterns, and promote the health of the ocular surface when dry eye was present.
Reference:
Arita, R., Fukuoka, S., Matsumoto, R., & Kaido, M. (2025). Effects of blinking exercises on palpebral fissure height and tear film parameters. The Ocular Surface, 36, 237–243. https://doi.org/10.1016/j.jtos.2025.02.003
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