Association between hyaluronic acid-containing artificial tear use and digital screen device-related asthenopia outcomes: a retrospective cohort study

To investigate the effect of a hyaluronic acid (HA)-containing artificial tear (AT) on the management of digital screen device-related asthenopia (DSA). A retrospective cohort study was conducted, and patients with DSA were categorized according to the treatment they received. A total of 120 and 88 patients/eyes were assigned to the non-HAUD and HAUD groups, respectively. The main outcomes included tear break-up time (TBUT), the Schirmer I test, meibomian gland dysfunction (MGD), ocular surface staining, and ocular symptoms. The chi-square test, independent t test, and a generalized linear model were used for statistical analysis. After the 3-month follow-up, the TBUT value was significantly higher in the HAUD group than in the non-HAUD group ( P < 0.001), whereas the Schirmer I test result did not differ significantly between the groups ( P = 0.319). In addition, the ocular surface staining rate ( P = 0.028) and the MGD ratios ( P = 0.958) were similar between the two groups. The incidences of soreness, fatigue, difficulty with digital screen use, and ocular irritation were significantly lower in the HAUD group (all P < 0.001). DED, prolonged digital screen use, and ocular surface staining were significantly correlated with poor treatment response in the non-HAUD group (all P < 0.008). In this retrospective cohort, use of an HA-containing lubricant formulation was associated with modestly better outcomes.